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FOR SERVICE CALL: SERVICE ORDER PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO.WOES004-D (1/17) 559-498-0240 WO 500 SERVICE ORDER NO. FOR ACCOUNTING CALL: WODIY 0 } 562-231-9550 N25.50466AF 110 };�• WORLD OIL ENVIRONMENTAL SERVICES- H ANTONINI ENTERPRISES LLC- LATHR00287 EAST MANNING AVt,PARLIER CA 93648 ANTONINI ENTERPRISES LI-C -A P 701 D�ARCY PKWY 1 559��s a24Q PO SOX 8468 E WWW.WORLDOILCORP.COM T LATHf�.OP,CA 05330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 08215 o (209) 993-8695 (209) 466-4900 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES ANTI308 R )UTE 124 1 SCHEDULED-1 DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 4/9%7018 4/2/2018 CAL000385703 PART#. DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL WO USED OIL/ MIXED OILS 100 W03C USED OIL SERVICE CHARGE 1 lQ BATCH Crops Streets; TOTAL CASH RECD: CHECK# Account Wiirlager:Steve Gately WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATEDTSDF: ALTERNATETSDF: fCi=F Ea 1QlUfOIQAN R�7� CA H536>�L�QB)6T13C(3�3d17 =w ••o t: DRUMS P/U: EMPTY DRUMS: FAC€LITY. BSC r s � GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) �j�� -,n� By signing below I hereby certify that: (Waste oil generator/customer MUST check ONE of the following three bol!-') / have not mixed any of the waste*5ctibed above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the waste does oo[contein any f'Cils.h h e complied wlttl th� gdlremettts of the af[plieal,le CaUfrxnia used oiltr13t1¢peplent regulatlarta to determine this Is true.I agree to accept the additional charges for the disposal of ihls waste if the information I have proved abohis [s Incorrect O@21 have not mixed any of the waste described above with any other hazardous waste,the total halide con tent is GREATER titan 1,000 ppm,and the waste does not contain any PCBs.1 Y have provided proper documentation to world oil 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 the information I have provided about this waste is Incorrect 1=0ThiswaseItfrom alank which mucusWa5teall fromItovsehGId do-H-yourself(Mand/or conditionally exempt small quantity generaTor(CESQG)sources,To the best of roy knowledge,the only wantu all conolned In niy DIY/CESQG collection tank Is saley from DIY andlor CESQG soutces.l have not miAod this waste oil with any other hazardous waste orwaste oil from other sources.I agree to accept the additional charges Tor&pasal of this wmie If the information I have provided atmut thh waste is lnca mr r (All generators/customers MUST read the following text and check the associated box.) 4 4)If I am a large qua ntitygent rator,Iz-ertify that I have a program in place w redure the vol umeand toxicity of WastergerMrated to the degree I have determined to be economically practicable and that I hava selected the practicable method of treatment,storage,or disposal currentlyavalhable to rrk which minlmizes the present and future rhrear w hurnan life and the envlronmenC Or,if I am a small quantity generator,I have made a good faith effort to minimize my waste generation and select the best waste management method that Is avallalrle to rrle that i can afford. This individual slyning 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 descriptions of waste and materials are true and accurate a3 packaged eked and labeled,are ready for transportation in accordance with applicable state and federal regulations,and that Customer shall abide and be bound by the Standard Terms and Conditions on the reverse side of th a lcc Order. 'St • ature Driver Si nature ll�fff De l �.�� [ate Print Name Print Drivers Name