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FOR SERVICE CALL: SERVICE ORDER PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM N0.WOES004-D (1/17) 559-498-0240 VIfO 500 SERVICE ORDER NO. FOR ACCOUNTING CALL: WODIY 0 562-231-1550 'fpr N2601260 AF 110 WORLD ENVIRONMENTAL SERVICES- H' ANTONINI ENTEERPRISES LLC- LATHROF4287 EAST MANNING AVE,PARLIERCA 93648 ANTONINI ENTERPRISES LLC- A P 701 D'ARCY PKWY 1-559-498-0240 PO BOX 8468 p WWW.WORLDOILCORP.COM E I) LATHROP,GA 95330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 95215 T (209) 993-8695 (209) 466-4900 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDERTAKEN BY HALIDES ANT608 R )UTE 124 O� JOHN SCHEDULED-I DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 6/29/2018 6/22/2018 CAL000385708 52>--a I(, -al(,PART# DESCRIPTION QTY UNITPRICE QTY PIU TOTAL VVOSC USED OIL SERVICE CHARGE 1 /� WO USED OIL f MIXED OILS 65 BATCH 0 Cro.is Streets: TOTAL CASH RECD: CHECK# Account Manager:Todd Aurit 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: DE5IGNATEDTSt7R k Ry EMjWWj0NMCNTAL ALTERNATETSDF: DRUMS P/U: EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION (PLEASE CHECKTHE APPROPRIATE BOX) By signing below I hereby certify that. 1,�,� (Waste oil generator/customer MUST check ONE of the following three boxes) LY�Pi)I have not mixed any of the wave described abovawfth any other hazardous wmte,the total halide content is LESS than I.D00 ppm,and the waste dors N%conGdn any PCEs i h,Wu tomplled MIS the requirements of Yt, applicable California used oil management regulaacni to determine this ks true,I agree to eecrpt the add1knal charses forthr disposal of thls waste if the Infe(matlon I have provided about this waste is Incorrect D#21 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 ally PCBs,I 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 043)This waste is from a tank which collects waste oil from liousehold"do-it-yourself"(DIY)and/or conditionally exempt small quantity generator(CESQG)sources.To the best of my knowledge,the onlywaste oil contained in my DIY/CESQG collection tank is soley from DIY and/or CESQG sources.I have not mixed this waste oil with any other hazardous waste or waste oil from other sources.I agree to accept the additional charges for disposal of this waste If the information I have provided about this waste is incorrect (All generators/customers MUST read the following text and check the associated box.) ray if r am a large gtia aty generator,I[erllfy that 1 have a program in place to iedttce the volume and lozkiry of wasteg'morated to the degree I have dewritilned to tie economically practkable and that I have RT&Ltad the practicable method of treatment.storage,or disposal currehtlyaval mie to mewltfdt minlmites the present and future threat to hunrart Ilrezrnl the emirortmenl;Or,if I am a small quantity generator,I have made a good faith effort to rrtlnlmiAs my waste generation and select the best waste manageurmat method that is available.to me that t can afford 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,tli a for ing descriptions 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 thatCustornet shall We and a bound by the Standard Terms and Conditions on the reverse side of this Service Order. a&Z'4 -71ald ru ❑mer Signatur Date D St nature Date rim V(y Y 0 -- Pririt amc Print Drivers Name