COMPLIANCE INFO_2023 - Laserfiche WebLink

Home Browse Search

AWSUHY tNVIHUNMENTAL SERVICES,DBA FORM NO.WOES002-B (5/18) FOR SERVICE CALL: 1-800-727-2879 r3 �, SERVICE ORDER FOR ACCOUNTING CALL: N `C 562-231-1550 WORLD OIL , ON � �O� ENVIRONMENTAL SERVICES 1300 S.SANTA FE AVENUE COMPTON,CALIFORNIA 90221 (800)974-4495 EPA#CAD028277036 Date — Customer# Customer D - EPA# [`,IG�I.CCO 2ZO7i Address PO# Commodity _ City State Zip�o Halides PPM Phon� Contact Amount Cash❑ Check# Note Waste Disposal Information NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS)STATE CODE 221 ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE ❑ NON-RCRA HAZARDOUS WASTE,SOLID(FILTERS CONTAINING OIL)STATE CODE 223 ❑ NON-RCRA HAZARDOUS WASTE,LIQUID(AQUEOUS PARTS WASHER SOLUTION)STATE CODE 135 ❑ NON-RCRA HAZARDOUS WASTE,SOLID(OILY PAPER/PLASTIC FILTERS/DEBRIS) STATE CODE 332 ❑ OTHER MAN I FEST NEXT SVC DATE DRUM SIZE QUANTITY_0 TRUCK NUMBER DESIGNATED TSDF: ❑ WORLD OIL RECYCLING*2000 N.ALAMEDA STREET*COMPTON,CA 90222'CAT080013352*(310)537-7100 ❑ WORLD OIL ENVIRONMENTAL SERVICES*2549 SCOTT AVENUE*CHICO,CA 95928*CAL000827844*(800)733-9043 ❑ WORLD OIL ENVIRONMENTAL SERVICES-CHICO II,LLC*1618 W.5TH STREET*CHICO,CA 95928*CAD980694103*(800)733-9043 ❑ WORLD OIL ENVIRONMENTAL SERVICES-FORTUNA*20D DINSMORE DRIVE*FORTUNA,CA 95540*CAL930256136*(800)733-9043 ❑ WORLD OIL ENVIRONMENTAL SERVICES*7300 CHEVRON WAY*DIXON*CA 95620*CAT080012602 (707)693-6008 YES MANAGEMENT,INC.*6500 US HIGHWAY 95*YUMA,AZ 85365*AZR000521146*(928)344-9828 - RAMOS ENVIRONMENTAL*1515 S.RIVER ROAD*W.SACRAMENTO,CA 95691 *CAD044003556*(916)371-5747 WORLD OIL ENVIRONMENTAL SERVICES-CERES*1920 MORGAN RD.*CERES,CA 95358*CAL000393680*(209)541-1825 ❑ BAKERSFIELD TRANSFER INC.*1620 BRUNDAGE LANE*BAKERSFIELD,CA 93307*CAL000282598*(661)377-0308 ❑ WORLD OIL-SAN JOAQUIN,LLC*14287 MANNING AVE*PARLIER,CA 93648*CAL000102751 *(559)498-0240 ❑ US ECOLOGY VERNON*5375 SOUTH BOYLE AVENUE*LOS ANGELES,CA 90058*CAD97030993*(323)277-1500 ❑ ALTERNATE FACILITY GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOA By si ning below 1 hereby certify thab (Waste oil generator/customer MUST check ONE of the following three boxes) ( 411)I have not mixed any of the waste described on the service order noted above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the wash does not contain any PCBs.I have wmplied with the requirements of the applicable California used oil management regulations to determine this Is true.I agree to accept the additional charges for the disposal of this waste If the Information I have provided about this waste Is Incorrect. (❑412)1 have not mixed any of the waste described on the service order noted above with any other hazardous waste,the total halide content Is GRFATER than 1,000 ppm,and the waste does not contain any PCBs.I have provided proper Bowmen tation to World Oil Environmental Services to rebut the presumption that this waste was mixed with other hazardous waste.l agree to accept the additional charges for the disposal of this waste If the Intonation 1 have provided about this waste Is incorrect (❑413)This waste is from a tank which collects waste oil from household"do-it-yourself"(DIY)and/or conditionally exempt small quantity generator(CESOG)sources.To the best of my knowledge,the only waste od contained in my DIY/CESOG collection tank is solely from DIY/CESOG sources.l 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) certify that I haves program In place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that 1 haveselected the practicable method of treatment,storage,ordisposal currently available to me which minimizes the present and future threat to human life and the environment. This Individual signing in the space set forth below on behagaf Customer represents and warrants that helshe has the authority to bind Customer that the forgoing descnption of waste and materials are true and accurate as packaged,marked and labeled,ars ready for nsportation in accordance with a Ircabiestate and federal regulations and that Customer shall abide and be bound by the Standard Terms and Conditions on the reverse side of thls Service Order. rNZI �2 (7,1,K CustoLure Date griature Date J r,� � &�> Y.i- �n Print Nam Print Drivers Name