Laserfiche WebLink
FORM NO.AES003 <br /> SERVICE ORDER <br /> No. N 658238 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON, CALIFORNIA 90221 ❑ (310) 886-3400 <br /> DIXON UNION CITY <br /> 1-800-727-2879 EPA CAD028277036 14888-603-8844 <br /> DATE - ONETIME PICK UP ❑YES or 0,NO <br /> CUSTOMER - > - RESIDENCE ❑ YES or ❑ NO <br /> BILLING ADDRESS CONTRACT CUSTOMER 12,YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE - ';; 7' L'-;: CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# rr ¢'i �r _ AMOUNT <br /> JOB SITE ADDRESS - CHECK NUMBER <br /> RO.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> ,V (AMOUNT) <br /> NOTES: �1 X71 U'P f/p COMMODITY <br /> A'?0 �Ca(jGKy5 A10 eJicwe'e- HALIDES r P.P.M. <br /> NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIL/MIXED OILS)STATE CODE 221 <br /> •NO PLACARDS REQUIRED' ' <br /> ❑ NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133' <br /> NO PLACARDS OR MARKINGS REQUIRED' NEXT SERVICE DATE )' <br /> ❑ OTHER DRUMS DRUM SIZE <br /> P <br /> MANIFEST NO. :#:` NO.OF GALLONS <br /> DRIVER TRUCK NO.&RT ": 11, _ <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City,CA,510-487-9277 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDF: ❑ BAKERSFIELD TRANSFER INC.-1620 E.Brundage Ln.• Bakersfield,CA 93307•CAL000282598•(661)377-0308 <br /> ❑ BAYSIDE OIL II,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(831) 427-3773 <br /> ❑ EVERGREEN ENV. •4139 N.Valentine Ave. • Fresno, CA 93722 .CAD982446882• (510)795-4400 <br /> DEMENNO/KERDOON •2000 N.Alameda Street•Compton, CA 90222•CAT080013352•(310)537-7100 <br /> 5, D/K DIXON.7300 Chevron Way•Dixon,CA 95620•CAT080012602•(707)693-6008 <br /> ❑- RAMOS ENVIRONMENTAL.1515 S.River Road .W.Sacramento,CA 95691 .CADG44003556 .(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named articles are properly classified,described, packaged, marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and are in proper condition for transportation, according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation..... <br /> •I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY _ <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATURE DATE <br /> •I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> CONTAINS ANY PC B'S. PRINT NAME <br />