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41 <br />FOR*SERVICE CALL! <br />DIXON OFFICE <br />1-600-7-ASSURY <br />UNION CITY OFFICE <br />1-888.603-8844 <br />CHICO OFFICE <br />800-733-9043 <br />i SIMS METAL - SIOC)KFUN <br />E 1000 .]. AURORA S f <br />o MONTHLY WO ONLY <br />T STUCKTON, CA 95206 <br />(209) 948-40014 <br />L� <br />SERVICE ORDER <br />ASBURY ENVIRONMENTAL SERVICES <br />1300 SOUTH SANTA FE, COMPTON, CA 90221 <br />1.310-886-3400 <br />-- T'(Z.(ofFSPORTER EPA # CA0028277036 <br />PORIA N0. AES004-6 yREV IN7I <br />SERVICE ORDER NO. <br />600 S 4TIA STR(:1'7 <br />RICHMOND,, CA 94804 <br />(Moo) 949-4000 <br />CUSTOMER# <br />PURCHASE ORDER# <br />ROUTE# TRUCK# I CONTACTNAME ORDERTA ENBY HALIDES <br />230 £70 <br />PO REQUIRED <br />12 �✓� HfINS LiINSCFI 7.b.i.tas <br />DATE REQUIRED <br />DATE ENTERED <br />NEXT SERVICE DATE CUSTOMER EPA # MANIFEST--#{./ <br />2/20/201:1. <br />12/19/201.1 <br />CAD029495074 odvIq (�j-J Jv` <br />PART# <br />DESCRIPTION QTY UNITPRICE <br />QTYPIU <br />TOTAL <br />WO <br />LISED OIL / MIXED OILS 295 KO.00 <br />$0.00 <br />1c10SC <br />USED 0:11. SERVICE CHARGE 1. $0,00 <br />$it. 00 <br />Cross <br />Streets. PAGE.Di <br />DRIV <br />R <br />TOTAL <br />CASH RECO: CHECK #. PLEASE PAY FROM THIS SERVICE ORDER <br />1,; WASTE DISPOSAL INFORMATION <br />NON•RCRA HAZARDOUS WASTE, LIQUID (USED OIL/NXED OILS)'NO PLACARDS REQUIRED' STATE CODE 221 <br />NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS)'NO PLACARDS REQUIREDt STATE CODE <br />OTHER: <br />DESIGNATED TSDF: RAMRS F VTRONMFNTAI _ IMS Sa-,QIYFR RD- Y- ckr-RANFNTO87 <br />- rA 95691. f71A) 371- 47. rADR44003556 <br />ALTERNATE TSDF: <br />SA RECYCLING: 33210 Westenn Avenue, Union City, CA 94887 1.510.487.9277 <br />ORUMSP/U: EMPTYDRUMS: FACILITY: BSC <br />GENERATOR WASTE CERTIFICATION <br />PLEASE CHECK THE APPROPRIATE BOX <br />This it to Comity that Me wMie dascnbed above 11 INopody classified,deecdb.d.packaged, marked And l oni and Is In properomm Mlen Am Manspoma(Im, sacording to.11tim d. slate <br />and federal regulations. By aigmn below I also basally Carofy that: <br />(Waste oil generator/customer MUST check ONE of the following three boxes) <br />❑ 01)A have AGI next d any Of aha waste deeMbad Amon win any OIMr haiudwa waste, the total halide comenl is LESS Man 1.0 W ppm, and Me wattle does Iwl Contain any PCBs, l have <br />compiled with Me r.quimpnts of IM appiuhle Ca ifomia used ell managerwal regulations to determine Ills I. kaa. I ague to accept the additional charges los the d.posat M this waste <br />it Me Informalion I have p.Ad" ahou( this waero is incorrect <br />n 1211 have not mixed any of In. ..at. dosanbed above with Any other 01ZArd0M3 waste, the total halide Camlem is GREATEN than I.M ppm, and the watt. does not eontaln any PC8a, I <br />have povided proOM decumenlalinn to Aelmr, Erwlrmnwnaal SaMex le rebut Ina preaumptian 6a1 Am..ease we.Onsad will Odrcr haeardaos waste. 11'.. Is lo.md the eGGia ne, cnam.a <br />AGO the disposal of this waste if the information 1 have nrovidad abwA this waste is incorrect <br />0 da) Me ..to Ie k0m a tank which CeMpcle waste YI from hwaehold "da ihywnalf IOIY) andim conditionally eaampt small quantity generMM ICESQGI source,. To the beat of my <br />knowladga, tM Dnly west. dl Contained in On, OIY) CESOG collwdon lank Is aalay Aram BAY'Mier CESOG .Domes. 1 have not mixed this wants oil with any Omar hazardous waste at <br />.1.all tram olhef neuro...).gt.e to aeanpl Me XWllmAub Ill.,,. ter disposol of MI. waste If MemfIXmaliM 1 have hoWilad albel this went. is in,.,,. <br />(All generators/customers MUST read the following text and ch a associated box.) <br />eaq It A an. As" 'oNpty genmaloq l .Oozy Mal l have a plogtam In place is reduce Me volume ami Watchy el waab genenlM tot d ao l have dalermmad to be economically <br />pracgaable and (hot l have ,Wi Me praCHcaple melhed d moaLn.ol.sbrag#,.Cd.pasal cunanlly available to m0 wlhoh w a ep and an lul a MOW to human life and <br />Me anninmmonh, Or, it A am a small quantity gmeramr, Ihave made a good faith effort to mm ontze my wast. generation and a cU be I w to managvmA I marred that is available <br />to me Met I can afford. <br />—I SCAa4 // <br />Cu-sWnher Signature Date <br />A'2,^n Rb6 /.X-&-4 <br />JC) <br />/t Date <br />