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F'Oh SERVICE CALL: SERVICE ORDER <br /> DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO,WOES004-B (4/17) <br /> 1-800-727-2879 SERVICE ORDER NO,�] <br /> FOR ACCOUNTING CALL: N2690716 <br /> 562-231-1550 <br /> WOFZLD OIL <br /> ENVIRONMENTAL SERVICES. <br /> s ANTONINI ENTERPRISES LLC- LATHROP 7300 CHEVRON WAY,DIXON CA 95620 ANTONINI ENTERPRISES LLC-A <br /> " 741 D'ARCY PKWY 1-800-727-2879 PO BOX 8468 <br /> P <br /> P WWW.WORLDOILCORP.COM <br /> D LATHROP, CA 95330 STOCKTON, CA 95215 <br /> T (209)993-8695 TRANSPORTER EPA#CAD028277036 <br /> 0 (209) 466-4900 <br /> CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES <br /> MIN I aV0 .trr�-uu NvnIN a�ulrttalla <br /> 'DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA i1 BILLof LADING/MANIFEST# <br /> 'I uW.ZU-I 6 UALUUIJ6b0 f u:j <br /> PART# DESCRIPTION QTY UNIT PRICE QTY PIU TOTAL <br /> of UZj'=U IvtC I ML VIL MN LJ LanCAU L1INC rIL i r--Ko r+ <br /> OFDR OiL FILTER DRUM REPLACEMENT-NO CHARGE 4 <br /> JOHN 209-466-4900 BATCH 9 <br /> Effective 7112019:Service orders with associated haz waste manlfeats(site specifc%onsoll Ited)are subjec to an EPA Fee. Fees cover EPA pass- <br /> through fee and administration of the eManifest program. Fees vary from$4-$10 based an N anlfest type, A iplicable fees will I r on your Invoice. <br /> CASH RECD: CHECK# <br /> WASTE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS) STATE CODE 221 <br /> TM KING OIL)STATE CODE 223 STATE CODE <br /> OTHER: — YUI &yE5t1.C,�T3nr-i'AnW�r M 1 636ia,92@ 299 _.. <br /> bESIGNATEDTSDr:_ <br /> AC:VIaf � ourTENlanageTdddullt <br /> DRUMS PIU EMPTY DRUMS; FACILITY: BSC np <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE 13%I11 OCT 2 5 2018 <br /> By signing below I hereby certify that: J LJ <br /> (Waste oil generator/customer MUST check ONE of the following three bila es) <br /> M#i)I have not mixed any of the waste described above with any othe(hazardous waste,the total halide content Is LESS i hj,i LOU ppm.o rid clip.wmie does not c a nta-.r[a ny FS,7�I.nY• pLtr+tie itlthemturcrn.•n:sof <br /> the applicable California used all management regulations to determine this Is true,I agree to accept the addhlonalcharges For the cilsposal01 this waste if the InFormotlon I Neve provided abrrul this waste is rca n=e1 <br /> D 921 have not mixed any of the waste descrlbed 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 <br /> 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 <br /> waste If the Information 1 have provided about thissvaste Islncorrect <br /> =00)-hls waste Is from it tank wlikh collects waste an from households to 1t-yrounr('(DIY)and/or conditionally exempt small quantity generalor(CESOG)sources.To the best of my knowledge,the only wast"'J contalried <br /> in my Dw cESRG cora ction tank h so ley from MY andfar CEM Souries.l hair flat m Ixed this waste all with a ny oth er hazardous waste or waste all from ath eF sources,I agree to accept the additional charges for d;sposal <br /> a l this waste I f t he information I have provided abo u t f his wa ste Is I n carrett <br /> f� (All generators/customers MUST read the fallowing text and check the associated box,) <br /> sM4)It I am,i large qi to ntitygeneretar,Ice rtify that I boor,a program In ptace In reduce the voiumcand toxlcliy ofwasle generated to the degree 1 have determined to be ecn nomically practicable and that i have <br /> selected the practtcalt:e method of ueaimenr,siorago,errdlspGsal currently available tome whlch minimizes the present and future threat to human life and:he environment;Or,If I am a smwl gwinWly generator,i <br /> have made a good faith effort to minimize mywaste generation and select the best waste management method that Is available la me that I can Mold, <br /> 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) <br /> hatt e forgoing descriptions of waste and materials are true and accurate <br /> as packaged,marked and labeled,are ready for transportation inaccordance with applicable state and federal regulations.and thatCuslamcrshatlall andbebaundbytheSlandardTermsandCanditionsonthereverse <br /> side of this Service Order. �(((,'''[���� <br /> t • -� / r <br /> 1� <br /> Cus mer SigrTatur Date Driver Tatt e D <br /> Print(llama D.fnr rlrt„n.e Af e.,... <br />