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FOR SERVICE CALL: SERVICE ORDER PARUER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) 559-498-0240 WO 500 SERVICE ORDER NO. FOR ACCOUNTING CALL: 562-231-1550 VtfODIY 0 2550 06 AF 110 WORLD OIL ENVIRONMENTAL SERVICES,,., ANTONINI ENTERPRISES LLC- LA rHROP287 EAST MANNING AVE,PARLIER CA 93648 559-498-0240 ANTONINI ENTERPRISES LLC-A P 701 D'ARCY PKWY PO SOX 8468 E WWW.WORLDOILCORP.COM D T LATHROP,CA 95330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 95215 0 (209)993-8695 (209) 466-4900 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES ANT608 ROUTE 124 IDDI 1 SCHEDULED-1 IDATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 9/26/2018 1/19/2018 CAL000385703 • f✓ PART# DESCRIPTION QTY UNIT PRICE QTY PAJ TOTAL WO USED OIL t MIXED OILS 90 WOSC USED OIL SERVICE CHARGE BATCH Cro 3s Streets: TOTAL CASH RECD: CHECK# Account Manager.Steve Gately WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATED TSDF: ALTERNATETSDF: ASB R ! ME RVIC S-GE , 620 ORG R[7.,C6RE8 358 5 i-TIM,CAU000303a DRUMS P/U: EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) �' 8 1 5 2018 By signing below I hereby certify that: }3 + (Waste oil generator/customer MUST check ONE of the following three b 5c!S n t f I have not mixed tiny of the waste described above wlth any other hazardous waste,the total halide content Is LESS than 1,000 pprn,and the waste does not contain any PCBs.I have compiled with the requirements of tl7e apl�li�able California used oil management regulationsto determine this is true.I agreeto accept the additional charges for the disposal of this waste If the Information I have provided aboutthls waste is incorrect 11:162 1 have not mixed any of the waste described above with any other hazardous waste,the total halide content Is GREATER than 1,000 ppm,and the waste does not contain any PCBs.I have provided proper documentation to World 011 Environmental Services to rebut the presumption that this waste was mixed with other hazardous waste,I agree to accept the additional charges for the disposal of this waste If t1w information lhave provided aboutthis waste is incorrect CJaal IN&waste is From a tankwhlch collects waste all from household do-At"yeurself"(DIY)and/or conditionally exempt small quantity generator(CESQG)sources.To the best of trty.krtowledge,the only waste till conralned In my DIPJ CESOG ro)lectfon tank is soley rram D1Yand/vr CESQG sakirces.i have not mixed this waste oil with any other hazardous waste urwaste oil from other sources.I agree to accept the'tddltional chatgoxfor disposal of this waste It the lnfoanatlon I have provided about this waste 4 incorrect (Ali generators/customers MUST read the following text and check the associated box.) II I am a large quamisy gerserato,I¢tify that I have a program In p16[e to reduce the volumo,and toxicity of waste genefated Tv the degree I have determined to beeconomlcally twacticable and that I have selertwI the practicablernethod of treatmeni,storagr,or disposal currently avallable tome which minimizes the present and future threat to human life end the enornimeni!Or,If 1 am a small quantity generator,I have made a good faith effort o minirrae my waste genera Lion and select the best wasic mamigementmethrsd that 15avallaOle to methal Ican affnrd• This individual signing In the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bind Customer,that the forgoing descrlptlons of waste and materials are true and accurate as packaged,marked and labeled,are ready for transportation in accordance with applicable state and federal regulations,and that Customer shall and be bound b Stan Idtd7erms and Conditions on the reverse side of this Service Order. V , sto er Signature Date er SI na ure Date _ � d Pins ame Print Drivers Name