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Mir r ASBURY � FOR SERVICE CALL: Ir BILLING ;� ?I ASBURY ENVIRONMENTAL SERVICES,DBA SITE OES AUTO REPAIR-MOFFAT BLVD CERES (800)974-4495 I OES AUTO REPAIR-MOFFAT BLVD 69 MOFFAT BLVD STE C MOFFAT BLVD STE C DATE ENTERED ORDER TAKEN BY WORLD OIL 2/11r2025 Gonzales, M ENVIRONMENTAL SERVICES- ANTECA,CA 95336 MANTECA,CA 95336 DATE REO ROUTE# In+ 300 South Santa Fe Avenue Compton,CA 90221 209)824-2633 (209)824-2633 CER-138 www.worldoilcorp.com NEXT SERVICE Transporter EPA#CAD028277036 PURCHASE ORDER# CHECK/CASH RECD SERVICE ORDER# CUSTOMER# CUSTOMER EPA# CONTACT TRUCK# N5654754 JOE 36 GAL000325856 TOTAL MANIFEST/BOL EST DTY ACTUAL QTY UNIT$ � # PART# DESCRIPTION 55 .9/1 $0.00 $0.00 AF ETHYLENE GLYCOL SOLUTIONS O%7G��07 ��I `7 CJ �� i For UEI TEST RESULTS— PASS FAIL) $8.00 $8.00 rl , EMC EMANIFEST EPA FEE ADMIN CONSOLIDATED MANIFEST 1 f I i - ACCT MGR',Samuel Read I CROSS STREETS. ' 1 STATE CODE 133 NONLR HAZARDOUS WASTE,LIQUID(EfHYI ENE GLYCOL SOLUTIONS) L' WORLD OIL ENVIRONMENTAL SVCS-CERES,t920 MORGAN RD.CERES,CA 85307 208 541-1925,CAL000393fi80 S it Y DISPATCH NOTES PAGCD DRIVER DRY RUN❑ f * DRIVER NOTES y ` m,and the waste does not contain any PCBs.I have complied with the requirements of the applicable California or Federal Used Oil GENERATOR WASTE CERTIFICATION:Used oil enerator/customer is REQUIRED to check one of the below options. ORA I have not mixed any of the waste described 7777ith any other hazardous waste,the total halide content is LESS than 1,a in pp is waste is incorrect. �r'f n� he total halide content is GREATER than 1,000 ppm,and the waste does not contain any PCBs.I have provided proper documentation to World Oil Environmental Services to rebut the Management of a 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 bout act. /f I have not mixed any of the waste described above with any other hazardous waste,t waste if he Information have provided about this waste is incorrect. 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 inimizes flier he waste or used oil from other sources.I agree to accept additional charges for disposalofthitext and sign below• a and This waste is from a tank which collects with of er ha household"do-it-yourto a(DI1�and/or very small quantity generator(VSOG)sources.To the best of my knowledge,the only used oil contained in my DIY/VSOG collection tank is solely from DIY and/or VSOG sources.I have not mixed this a All generators/customers MUST read the follow g associated qq behalf of customer represents and warrants that he/she has the authority tord to the revgrse side of this Service Order.Service Orders rwith ials aan re tn" forgoing Dice. C if that I have a program in place to reduce the volume and toxiThis geneity rated thto the degree i nave e space set forth below on behtermlld to be economicallyand thatcuPtomershall abide by the Stalndard Termsected the aand Conditions le method of tteatment,storage,or disposal currently available to me which miry' !�IfH1 certify i% the present and future threat to human life and the environment. accurate as packaged,marked,and labeled,are ready for transportation in accordance with applicable stale and federal regulations, � 1` hazardous waste manifest(either site specific or consolidated)are subject to an EPA Fee.These fees cover the EPA pass-through fee and administration of the eManifest program.These fees vary basedr �type.Applicable fees will appear on your bdlmgtevo e' / Driver Full Printed - ! vaoesmi .�.� Driver Signature Date JbJ�G1 c a f #jw�A Dat me Customer Full Printed Name Customer Signature - •