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FORSOOV, IJ. LUIL /:74HM
<br />DDeON Or#10E
<br />1-900-7 ASSURY
<br />UNION CITY OFFICE
<br />1-888-603-8844
<br />CHICO OFFICE
<br />800.733-9043
<br />SERVICE ORDER
<br />ASBURY ENVIRONMENTAL SERVICES
<br />s 1300 SOUTH SANTA FE, COMPTON, CA 80221
<br />H
<br />I 1-310.886-3400
<br />P ;,i; » L>^•hi{ (;fiy. .. TRANSPORTER EPA # CAD028277036
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<br />0 �i:QgS4132.14i�"`
<br />No. I)OJ r. f
<br />FORM N0. AES004.8(bEV 1 )
<br />SERVICE ORDER NO. ..
<br />"J1 �7�ti?res$
<br />PCX Ii PLn-L - i%.4Rc::rq
<br />P £r. ,C` o1x - rx:.L.i
<br />e.. ani £ls.lit
<br />PQRTLAi.io ';iR: R72Dill
<br />91164 ;1e:1_i.'a":'.:✓
<br />CUSTOMER #
<br />PURCHASE ORDER #
<br />ROUTIE#
<br />I TR-UCK #
<br />CONTACT ME
<br />ORDER TAKEN SY
<br />ALIUES
<br />Via.}
<br />GAR Lf
<br />:,&iisfa
<br />DATE REQUIREQ
<br />DATE ENTERED
<br />NEXTSERVICEDATE
<br />CUSTOMEREPA#
<br />MANIFEST#
<br />7M1A:x'01;
<br />C?+I,t)rl`.3:' -;q
<br />PART #
<br />DESCRIPTIONQTY
<br />UNIT PRICE
<br />I QTY PIU
<br />IT,
<br />(((*3% 4,:i,.CF2i.P ,;1iEGvll i'il::'i'9r,,:�j :.
<br />F %t14c
<br />iSRA FLUID t'`E@ x'131.; t1
<br />::Ic
<br />s SneSis. '_,�:a: v'U�: � €:�; F:,_ia `�CIf.7't, {"`•rt�;zvl� ;:.�
<br />TOTAL
<br />CASHREC'D: CHECK# PLEASE PAY FROM THIS SERVICE ORDER
<br />WASTE DISPOSAL INFORMATION
<br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXED OILS)'NO PLACARDS REQUIRED- STATE CODE 221
<br />NON-RCRA HAZARDOUS WASTE, UQUiD (ETHYLENE GLYCOLSOLUTIONS) *NO PLACARDS REQUIRED* STATE CODE
<br />OTHER:
<br />DESIGNATED TSDF:
<br />ALTERNATE TSDF:
<br />SA RECYCLING: 33210 Western Avenue, Union City, CA 94587 1.510.487-8277
<br />DRUMS PN: EMPTY DRUMS: FACILITY: BSC
<br />GENERATOR WASTE CERTIFICATION
<br />PLEASE CHECK THE APPROPRIATE BOX
<br />TWO It to eertily den the wan daCdbed above is propany d49140a41, 040iMbed Packaged, marked and 10,111d, and is in proper condition for If-tl4po11Hlo0, BC"Aq to applicable Stott
<br />and Auhnat rogutadona. ey shining below Ohio hereby cotlry, thsL
<br />(Waste oil generator/customer MUST check ONE of the following three boxes)
<br />0 41)1 halt not mixed any of the wee, dexriMd shove wIM any anter ha:ardauawaua, the local hstl0e content is LESS Man 1.001 ppm, and the waste ones not contom any PCgsa have
<br />aomphod with the roquinmoma, oft" applicable California ueed oil managamonr rogulatlons to datprnme fills Is Iras, l agroa to accept Me additional Charges for the dmpoeal of this...
<br />if the mrormstiao i have Provided 40ou1 this waste Is incorrool
<br />0 A2)4 halo not mixed any or the waste dacdbod above with DAY other heardoue w -a,, the total halide content is GREATER than 1,000 ppm, and in. wap ORION not content any pC9e. I
<br />AD" provided proper documamadon to Asbury Environmental Sonvicas to rebut Ali, umpllM that this wets was m,ad wkh other hoaanloua Watla.i agreeth apcepl Meeddi4nnal charges
<br />forma diapoeN of Mie waste if Me imam 000 I naw provided about (hies waste it McorroCl
<br />Oa0)Thiswasi-to(tom a lankwhish coh,etD was,.1 Imm"00911-oo-14younelr(01Y)andiorcmMi0onally exempt small quanOty, panararof(CE5GG) saurcae. Toth. bato(my
<br />knawtedge, Pro Milt' MM OR contained In MY DIY$ CES00 W1001laYt tank is Way from 0lY sndmrCESOG aborb,C rR4ve dot mixed this weAto OR with any other haterdoyo waste w"
<br />waste off from Whar aoureas,lagrs- to ascapl me"thlional chases -for doppaal At this wasp If me Information I ht pr.NoM about thiswax, Is mcom0l
<br />(Ali generators/customers MUST read the following text and check the associated box.)
<br />O 54) lit am a Hrge quantity gsnersivr, I corlify that i have a program in play, reduce Ihs roWmq and toxicity of waele generated, the degree 1 heves de,rminad to be economically
<br />pr-cNcable and Mat t have wecctad file ptaa4paWq method of lreatmeny smraga, or dillk sal cprrentiy flesilibit to hat which min'en#es the present and futuro thnial to homes g, and
<br />IM awlronmera; 05 It I am a small quay iify generale'. 1 have nude a 960014110 attar{ to mir imda my walla veneration am select the beat was, manggamgnl mamod 144, N bslisb al
<br />to me Mel,( son'Itim,
<br />4ilverSignature Date
<br />Print Drivers flame
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