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FOR SERVICE CALL: SERVICE ORDER <br /> PARLIER ASBURY ENVIRONMENTAL SERVICES, IBA FORM N0.WOES004-D (1/17) <br /> 559-498-0240 WO 500 SERVICE ORDER NO. <br /> FOR ACCOUNTING CALL: WODIY 0 <br /> 562-231-1550 }I, N2572249 <br /> AF 110 <br /> WORLD OIL <br /> ENVIRONMENTAL SERVICES,. <br /> H ANTONINI ENTERPRISES LLC- LATHR010287 EAST MANNING AVE,PARLIER CA 93648 ANTONINI ENTERPRISES ERPRISES LLC A <br /> P 701 D'ARCY PKWY 1-559-498-0240 <br /> PO BOX 8468 <br /> E WWW.WORLDOILCORP.COM <br /> E <br /> T LATHROP,CA 95330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 95215 <br /> 0 (209) 993-8695 (209) 466-4900 <br /> CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES <br /> ANT608 R )UTE 124 ' W SCHEDULED-1 <br /> (DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# <br /> 5/14/2018 5/7/2018 CAL000385703 <br /> PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL <br /> WOSC USED OIL SERVICE CHARGE 1 10 <br /> WO USED OIL 1 MIXED OILS 60 <br /> BATCH <br /> Gro 5s Streets: TOTAL <br /> CASH RECD: CHECK# Account Manager: Steve Gately <br /> WASTE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE <br /> OTHER: <br /> DESIGNATEDT5DF: SSt�Ri'-Ei�dki �hi11#EIF h@i�P�d f � <br /> ALTERNATE TSDF: �' �fl <br /> RESTeAviam <br /> DRUMS P/U: EMPTY DRUMS: FACILITY: BSC <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) , <br /> 1q�4� <br /> •. By signing below I hereby certify that: <br /> (Waste oil generator/customer MUST check ONE of the following three boxes) �l . <br /> "9901)1 have not mixedany of the waste described above with any other hazardous waste,the total halide content Is LESS than 1,000 ppm,and the waste does not contain any PCBs.I jtomplled,wlfh'the requirements of <br /> r/ the applirableCallfornla used oil management regulations to determine this is true.I agree to accept the additional charges forthe disposal of this waste ifthe Information I have prfma'a#cut sibs waste Is incorrect <br /> =1121 have not'mlxed any of the waste described above with any other hazardous waste,the total halide content Is GREATER than 1,BBo ppm,and the waste does not contain any PCBs.I <br /> 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 <br /> waste if the Information I have provided about this waste Is incorrect <br /> Mit3]Thfs waste Is from a lank Which colleYawatie oil from Haus&huEcl"dn-lt-yourself'(pil')and/or conditionally exempt small quantity generator(CESgG)sources.To the best of my knowledge,the oniywaste CAI contained <br /> In my WiCE545 collection tank is coley from OIY andfud CESgG sou+ces.I have not mixed this waste oil with any other hazardous waste orwerste oil from other sources.I agree to accept the additional chArges for disposal <br /> of this waste if the information shave ptovldod about this waste is incorrect <br /> (All generators/customers MUST read the following text and check the associated box.) <br /> h1Y <br /> flam am a largegtiantlty generator I cprrify that I have a prograln h+prate to reduce the volume and toxicity of waste generated io the degree I have deturmined to he economically practicable and that I have <br /> retested the practicable method of treatment;storage or disposal currently.avaifabie to mevd+r;}i Minimizes the piesent and future threat to tiutnan life and the envlronmem;Or,If I am it small(iumntiiy generator,I <br /> have made a good faith efforr to minimize my waste generation and soject the best waste manaoernem method that Is available to me that I ran afford- <br /> This individual signing In the space set forth below on behalf of Customer represents and warrants that Ice/she rias the authority to bind Customer,that the forgoing descriptions of waste and materials are true and accurate <br /> as packaged,marked 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 <br /> side of this Service Order. <br /> � " Chu / <br /> C stomerSignature Date D1'iv rSignature Date <br /> Print Name <br /> PrTUvers Name <br />