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_ SERVICE ORDER <br />- No. N 4 31. 2 <br />ASOURY ENVIRONMENTAL SERVICES <br />2100 NORTH ALAMEDA STREET ❑ COMPTON, CALJFORNIA 90222 O (310) 886-3400 <br />SAN DIEGO OFFICE NORTHERN CALIFORNIA <br />1-800-748-5744 EPA CAD028277036 1-800-727-2879 <br />1-800-933-9194 <br />DATE <br />ONETIME PICK UP Cl YES or [14,40 <br />CUSTOMER - _ + . <br />RESIDENT ❑ YES or [3; NO <br />—_ <br />BILLING ADDRESS <br />CONTRACT CUSTOMER CVES or ❑ NO <br />.. <br />PHONEf ` *; 17/ CONTACT <br />CUSTOMER .•NL -11y7 —? ,, <br />—_ <br />CUSTOMER EPA x —---'�`�� i' ` 7,, — - <br />AM NT _---- <br />JOB SITE ADDRESS <br />EiVEDfitpeti <br />___— <br />CH K NUMBER — —REP. <br />P.O. NUMBER <br />/_9 2 7 <br />CROSS STREETS PQ_ NO <br />CASH RECEIVED — <br />_ —_ <br />�— <br />(AMOUNT) <br />Line No. <br />4.. <br />— <br />NOTES: _ <br />COMMODITY <br />Receipt Doe. <br />'� <br />—,_Pit <br />HALIDES .a`�:''�``�'" PP.M. <br />• NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXFD OILS) STATE CODE <br />*NO PLACARDS REQUIRED* <br />❑ NON-RCRA HAZARDOUS WAS -Fc , LIQUID (ETHYLENE iYLENE GLYCOL. SOLUTIONS) STATE CODE <br />NEXT SERVICE DATE ?`¢* <br />*NO PLACARDS OR MARKINGS R`.EOUIRED' <br />C; OT HER -- <br />DRUMS—DRUM SIZE <br />.---_-.—� :-� <br />MANIFEST NO. •�--^---'�"`-� ,, <br />=-`�. w} �' ---- <br />NO. OF GALLONS ---- <br />DRIVER "'�` ---_----_—_-- <br />TRUCK NO. & RT ve^ _----- <br />❑ NON HAZARDOUS DRAINED USED OIL FILTER __----—_--_—_— <br />❑ COMMERCIAL FILTER RECYCLING, 33210 Western Avenue, Union City, CA, 510-487-9277 <br />❑ ALTERNATE FACILITY -------_---- --- <br />-- -------- <br />DESIGNATED TSDF: C AI-VISO INDEPENDENT OIL - 5002 Archer Street • .Alviso, CA 95502 • CA1000161743 • (408) 262-1360 <br />BAYSIDE OIL II, INC. • 210 Encinal Street • Santa Cruz, CA 95060 • CAD088838222 • (408) 427-3778 <br />❑ ARTESIAN OIL RECOVERY INC. • 2306 Magnolia Street • Oakiand, CA 94067 • CAL000233905 • (510) 839-4234 <br />❑ D'eMENNOi KERDOON • 2000 N. Alarneda Street • Compton, CA 90222 • CAT080013352 • (310) 537-7100 <br />❑ OCS -'255 N. Marks Street. • Fresno, CA 93722 • CAD980673842 • (559) 485-5496 <br />RAMOS ENVIRONMENTAL ^ 1515 S. River Road -W. Sacramento, CA 95691 • CAD44003556 • (916) 371-5747 <br />C! ASBURY ENVIRONMENTAL SERVICES • 2549 Scott Avenue • Chico, CA 95928 • CAL000827844 <br />- ALTERNATE F4.CILIT`! <br />USED Oil_, USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named artiples are properly classitied, described, packaged, marked <br />RECYCLED AT OUR SISTER COMPANY D€ME:NNO/KEPDOON THE and labeled, and are in .roper condition fdi transportation, according to the applicar•la mgl_Istiol•s of <br />LARGEST P,ECYCLER OF USED OIL. IN THE WESTERN UNITED STAT E.E. tha Departmentof Transportation. <br />*1 HEFIEBY CE=RTIFY T IAT i How E NOT MIXED T HiG WASTE WITH ANY <br />OTHER WASTE, TH,9T lf'E rt�_iNi IG:.'c :RE i ESc; THAN iOOC P.RM.:-_ .. <br />AN^ TNfl THE YYi STE 1X:E.S Ni.). CONE"d� .'�rJl' P.Cf3'S . `------7_U4T_0 F1 S.'GWUaE - - BATE. <br />'I FURTHER AGFtFE l O A(;CE%'''T THt: , vD0!Tl-.7,i`lAI. CHARGES ':'OR LEGAL X <br />D!SPOSAI_ I•' -i HIS `NA4;7I: It= OV -1-P 10V0 RY.Nf. TOTAL HALIDES, Oil <br />C0NTP,!n1S i*r•J'r RCA's. <br />PRINT NAME <br />