COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

FOR SERVICE CALL: SERVICE ORDER DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA FORM NO. VdOES004 B(8/18) 1-800-727.2879 SERVICE ORDER NO. FOR ACCOUNTING CALL: 562-231-1550 WORLD Q I L ENVIRONMENTAL SERVICES. s 7300 CHEVRON WAY,DIXON,CA 95620 " ANTONINI ENTERPRISES LLC-LATHROP 1-800-727-2878 ANTONiN! ENTERPRISES LLC-A P 701 D'ARCY PKWY WWW.WORLDOILCORRCOM PO BOX 8468 oTRANSPORTER EPA#CAD028277036 T LATHROP,CA 95830 �.`_ STOCKTON, CA 95215 (209) 995-8695 (2091 466-4900 w CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES ANT608 ROUTE 124 JOHN SCHEDULED-1 DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING/MANIFEST# 2/11/2019 215/2019 CAL000385703 PART# DESCRIPTION OTY UNIT PRICE QTY P/U TOTAL WOSC USED OIL SERVICE CHARGE 1 kn o WO USED OIL MIXED OILS 180 JOHN 20,q.466-4900 BATCH# TOTAL CASH RECD: CHECK# WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIUMIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATED TSDF: SRU ff-iffWtR0NMEh 0t�fCtR lii�EREu- 95358-(209)W-1825;eAtOB0393680 ALTERNATE TSDF: �. r C,ow Sb outs. At"upit Mang" ftn Read DRUMS PN: EMPTY DRUMS: FACILITY: BSC r, it + I I!l),� GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIA 11 1" By signing below I hereby certify that: � � 1 19 2019 (Waste oil generator/customer MUST check ONE of the following three bio es) �!)t have not mixed any of the waste described ntxwo with any other hazardous waste,the total halide content is LESS than 1,0(14 ppm,and she waste dose not contain any PrAG,1 have cMnplled with the tequlremonts of the applicablo California used oil management regulations to dotgrmine this la true,l agree In accept the additlonat charges�uillpeJilspasaloi thtsvrosle If the Information I have provided abaci iiia waaia Is Incorrect l� u 021 have not mixed any of the waste,descrlbed above with any other hazardous waste,the total hallde content Is 01`15ATEn than 1,1}�ppm,and the waste does not contain any pG�s have provided proper documaniatilm to World ON Envirotrmenlai krvlces to rebut the presumption that this msla was mixed with other hazardous waste.I agree to aeoopt the a4(100'_al charges for the dlspoosl of this waste If the Informatlon I have provided about this waste is incorrect 0 #a)This wants Is from a lank which vollects vrasla oil from household ND -yourself"(p1Y)anNor conditionally exompt smell quantity generator(CE5OO)saorces.Td the beat of my knowledgo,the only waste oil eentalned In my OW CES00 collection tank Is soloy Irom DIV andfor USOG sources.I have not talked this waste oil with any other hazardous waste or waste all !rent other sources_I agree to accept the additional chernas for disposal of this waste it the Information I have provided about this waste Is Incorrect (All generators/customers MUST read the following text I cettrfy that I have a program In plata to reduce the volume and toxicity of waste generated to the degree I have determined to be economlcally practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human life and the environment. This Individual slgeing India apaco set forlh below on belialt of customer represents and warrants that hdshe has the authority to bind euMomer,Piet the forgoing descilptlons of waste -and materlala are Irue and aoeursS0 as packaged,marked,and labe}ed,are ready forlransporlatlon in accardancowithaYEJ guietions,and that customershallabide by the SkandatdTerms and Conditions an tin reverse side of this Service grder.Servlco Orders with an associated hazardous waste mantles[(either site specific or consolidated)are subtestto an EPAPA pass-through fee and adminislm{ion al lhecM fest regram. These le very based on Manifest type.Applicable fees will appear on your bl ling tnvalce. Cus Omer gnature Date Driver Slgq6tirre Date k�ama ntriver Name .::'