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FOR SERVICE CALL: SERVICE ORDER <br /> PARLIER ASBURY ENVIRONMENTAL SERVICES, DBA FORM N0.WOES004-D (1/17) <br /> 559-498-0240 - SERVICE ORDER NO. <br /> FOR ACCOUNTING CALL: <br /> 562-231-1550 N2626317 <br /> WORLD OIL <br /> ENVIRONMENTAL SERVICES,,, <br /> H ANTONINI ENTERPRISES LLC- LATHROW87 EAST MANNING AVE,PARLIER CA 93648 ANTONINI ENTERPRISES LLC-A <br /> p 701 D�ARCY PKWY' 1-559-498-0240 <br /> PO BOX$468 <br /> P WWW.WORLDOILCORP.COM <br /> E <br /> ° LATHRQP,CA 95330 TRANSPORTER EPA#CAD028277036 STOCKTON, CA 952'15 <br /> T (209) 993-8695 (209) 466-4900 <br /> CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES <br /> ANT608 ROUTE 124 JOHN SCHEDULED-1 <br /> DATE REQUIRED DATE ENTERED NEXTSERVICk DATE% CUSTOMER EPA# BILL of LADING/MANIFEST# <br /> 7/30/2018 7/23/2013 CAL000385703 0 <br /> PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL <br /> 1AJOSC USED OIL SERVICE CHARGE 1 9 ) 0 <br /> WO USED OIL/MIXED OILS 40 <br /> BATCH# <br /> Effective l/ /2018:Service orders with associated haz waste manifests(site specific/cansolida ed)are subject to an EPA Fee, ees cover 'PA pass- <br /> through fee and administration of the eManifest rooram. Fees vary from$4-$10 based on M Inifest type, 0cable fees-Wdl a T6kon four Invoice. <br /> CASH RECD: CHECK# <br /> WASTE DISPOSAL INFORMATION <br /> >t 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 /> DESIGNATEDTSDF: ASBURY ENVIRONMENTAL SERVICES-CERES,1920 MORGAN RD.,CERES,CA 95358(209)541-1825,CAL000393680 <br /> ALTERNATE TSDF: <br /> LTERN_TETS F: ftount Manager:Tadd Aunt <br /> DRUMS P/U: EMPTY DRUMS: FACILITY: BSC <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) <br /> By signing below I hereby certify that: <br /> (Waste oil generator/customer MUST check ONE of the following three boxes) <br /> M7))have not rrtlxed any 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 PC82r I have complied with tite R n f <br /> the applicable Callfornla.used oil management regulations to determine this Is true.)agree to accept the additional charges for the disposal of this waste If the information I ra w rt t as e p carte t= <br /> ptt2 I 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 ny 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 he addip I h� s foP�her�rNaal of this <br /> waste if the information I have provided about this waste Is Incorrect r) ,L IJ+0 <br /> O#3)This waste is from a tank which collects waste oil from household"do-it-yourself"(DIY)and/or conditionally exempt small quantitygenerator(CESQG)sources.Tothe be my�knowwage.the only waste oil carltal d <br /> 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.)ag accept;ite.a'Idttlauatcharges faadfspa I <br /> of this waste if the info(matlon I have provided about this waste is incorrect <br /> (AII generators/customers MUST read the followin!thatCLLstomer <br /> Fabitd'ea <br /> check th ociated box.) <br /> If I am a 1a rge quamllygenefator,I eenlFy that I have u program in place to reduce the volume and tonclty of waste generhour deter ed to be conbmfcally practicable and that I have <br /> elected the f,rncticahle method of treatment.,toraae,or disposa4 currently available to me which mi nimlzes the pre sent and fn life the envlro tent;or,IF I am a small quantity generator,I <br /> have made�good faith effort to ntinimizc my waste geneiativn and[elect the hest wade management rneihad that b availabfor. <br /> This individual signing in the space set forth below on behalf of customer represents and warrants that he/she has the authtttitgtattite fat descriptions of waste and materials are true and accurate <br /> as packaged,marked and labeled,are ready fortranspartation in accordance with applicable state and federal regulations,and abide a n bo d by the Standard Terms and Conditions on the reverse <br /> side ofthis Service Order. <br /> .. <�, 1 —5 <br /> / /.�er Signature path ignature Date <br /> F0. S Its <br /> tint Na n1e Print Drivers Name <br />