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<br />FOR'SERVICE CALL:
<br />DIXON OFFICE
<br />1$00-7-ASBURY
<br />UNION C1rY OFFICE
<br />1.888-603-8844
<br />CHICO OFFICE
<br />800.733-9043
<br />SEMS MF-'TAL -- S'1'OCY.ICIM
<br />1000 S. AURORA ST'
<br />MONTHLY WO ONLY
<br />S f OCKTON, CA 95206
<br />(209) 94H-4000
<br />E
<br />SERVICE ORDER
<br />ASBURY ENVIRONMENTAL SERVICES
<br />1300 SOUTH SANTA FIE, COMPTON, CA 90221
<br />1-310-886-3400
<br />-- '-'.30gW. SPORTER EPA # CAD028277036
<br />FORM IO.AES00a9(REV IWT)
<br />SERVICE ORDER NO.
<br />Irl1 39I;601,
<br />600 S 4TI-I STRE:li:T
<br />RICHMOND„ CA 94904
<br />CUSTOMER# PURCHASEORDER#
<br />ROUTE#1
<br />TRUCK#
<br />CONTACT NAME
<br />-111 l n cav,
<br />ORDERTA EN BY
<br />230;8(h F'0 REQUIRED
<br />1.12
<br />54 H41,18
<br />BINSCH
<br />//HAUDES
<br />I.b.i.tas
<br />DATE REQUIRED DATE ENTERED
<br />NEXT SERVICE
<br />DATE
<br />CUSTOMER EPA #
<br />MANIFESTT#
<br />12/20/2011 12/1.9/203.1.
<br />CAD029495074
<br />ri{-�//
<br />06V 1� ( ,/(-/rte
<br />PART #
<br />DESCRIPTION QTY
<br />UNIT PRICE
<br />QTY P/U
<br />TOTAL
<br />WO
<br />USED Dal_ / MIXED 0IL,S 295
<br />$0.00
<br />$0.00
<br />UOSC
<br />USED DIL SERVICE CHARGE 1.
<br />0.00
<br />$0.00
<br />Crss
<br />Street:,:
<br />PAGE.
<br />DRIV
<br />R'
<br />TOTAL
<br />CASH RECD: CHECK# PLEASE PAY FROM THIS SERVICE ORDER
<br />WASTE DISPOSAL INFORMATION
<br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED OILIMIXED OILS)'NO PLACARDS REQUIRED' STATE CODE 221
<br />NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) `N0 PLACARDS REQUIRED' STATE CODE
<br />_
<br />OTHER:
<br />X
<br />DESIGNATED TSDF: RANDS ENVIRONNFNTAI _ Ii !119 S. RIVER RD V M RRAM N10 CA 95691 (91 A)371-5747, PA0:44003556
<br />ALTERNATE TSDF:
<br />SA RECYCLING: 33210 Western Avenue, Union CRY, CA 94587 1-510-487-9277
<br />DRUMS PN: EMPTYDRUMS: FACILITY: BSC
<br />GENERATOR WASTE CERTIFICATION
<br />PLEASE CHECK THE APPROPRIATE BOX
<br />this is td, --mill that Me wrote daecnbed shove Is 1.1dy -ha.ihed, described, pat,-a,td, marled and labeled, and is In proper condition ran trgosporeim, atcwding to apphaable State
<br />and IedenbegWeflonl. Bs florin, blow 1 also hereby comics in ah
<br />(Waste oil generator/customer MUST ched( ONE of the following three boxes)
<br />0 0111 have not mix ed any of IM waste deaedbed above with any other hazardous, waste, the 10161 halide content If LESS Mm 1,000 Ppm, and We wash does not contain ant PCBs. I hove
<br />compiled with the requirements of the app, Cade Ceifomia used oil mma9emo it einifa(iona la de(ermino u,la le m1-. I -rice. to .,.pt the additional Charges for In. dlepofY of this waste
<br />,f the Information 1 havo provided about this wexh ie income -t
<br />0 R)1 base not mi.ed any of Mo waste deeCdbed above with any other ba icnious waste, the total halide content Is GftFATER than I.M ppm and Ino waste does not Contain any PCBs. I
<br />Mveprovidedpauperd astsit i,intomatiny En -ire cv;Clel aboutum rase!Ire Prefumvtion Marmil waea wm miaad with ether hazardous wan<.1 aorto bacaepr Ma oWlpor,ulcNrgu
<br />for Mt dsposN 01 Uis wuu it she information i nava mvria.d about this waste Is incwaed
<br />0 03) SNa Ovu'.4 Item a Imk which codoch wortsr oWm
<br />dl from household' do•it-yourso at) anconditionally exempt small qumuty generator (CESQGI limpats. To the moll es my
<br />-..Indy,, IN only wall. el Contained in On, ON, 00SQG eor"Ilon (golf Is so101 hen Oil arMlor CESQG cunuCn.I havo nor mMed this waste oil with any other hazardous waste es
<br />wafts ori Gogo -In- aeuaeea. l ogres IP accept it,, additional charges for dapoeal of Wig wasp if the information I have Provided about this woeh is Wcorrnn
<br />(All generators/customers MUST read the following text and
<br />0 a41 111 em a large quantity 9tnenlo , I ce,lify Ibut 1 have a program In plan to reduce the volume and loaklly of waste genu
<br />praCtkkile and Mat t have aeNded Me pnndghe method of treatment, atora9e, or deposal mmOnlly x,ailabis to m0 which ml
<br />Me eminnmanl, 0, if I am. ama)I mlgolity generator, I have meds a,00d Ialth effort IP minimin my wash gemudon end at}
<br />Ia me thin I can ,Hord.
<br />P-1, .---A'
<br />Cus a er Signatures Date
<br />JD
<br />assodated box.)
<br />I, I N. Getormired to be oconomicahy
<br />for anrm a threatm
<br />to human the and
<br />a manao.. I melned Incl is evailaMa
<br />Date
<br />
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