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3460 Naglee Road <br />July 26, 2018 <br />PHOTO 9: Consolidated manifest without the driver's si <br />nature. <br />__'--�• <br />OR SERVICE CALL. ..-:- <br />.... .. .. . .. <br />SERVICE ORDER <br />.. <br />A11URY ENVIRONMENTAL SERVICES. DBA <br />1RA L ^.t <br />Z_�?/�'"� <br />FORM NO WOES004-D0 It!111 <br />SERVICE OHUFR NG. <br />WORLD OIL <br />ENVIRONMENTAL SERVICES, <br />14287 EAST MANNING AVE, PARLIER CA 93648 <br />1 <br />1-559-498-0240 <br />WWW.WORLDORCORPCOM <br />.. . . <br />TRANSPORTER EPA # CAD028277036 <br />NEXT SERVICEFDATE CUSTOMER EPA <br />j1. ..:.f i... <br />U <br />CHECK# TOTAL <br />R, -RA HAZARDOUS WASTE, LIQUID (USED OIL/MIXED DASTE ISPOSAL INFORMATION <br />OILS) <br />RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) STATE CODE 221 <br />P _ STATE CODE <br />. NATEDTSDF <br />NATE ,.,t <br />TSQF: ... 1` <br />EMPTYDRUMS: FACILITY:_ BSC --- <br />GENERATOR WASTE CERTIFICATION (PLEASE CHECK THE APPROPRIATE BOX) <br />(Waste oil generator/customer MUST check ONE of the following three boxes) <br />f� 11C�maMai�Sgi wlh y Cher Mz d or al hat de Conten' LESS ti- 1 <br />,'100 ppm and the waste does not Conran yPCB 11,111-IIM hh qor e sof <br />CPSbd h p h add'[o harges for thed'sposal of the waste'(the'nformato Ih p dh ;h M1swastesncorrtttnt <br />W tMhary— h I <br />un nh+kBrWfPP Ertvu IS o Ih lld.c alle-1 iR ban nmelwl,WOppm and the waste does not con 'Id", �: F.ays provided appy, thnwashe s, r. p(honthattliswute wasmiretlwthotherhazartlouswasto.lagree to accp le,rddlt'onalchahgez for the d'sposai of tM1ls <br />lr <br />(�vo-fty yrself m'i antl/ttconditlonally exempt small quantity geleratnr (CESQLI. - To th, b,zt of my kn 1,dge. the only wasteollcnntained <br />�Mt P'bteo withany otherh-edouswasleor waste til lr Ih nurses lagree to accept theaddtlonaI,Kngesfortlbposal <br />T...tea d the following text and check the associated box.) <br />hfMtmtkl(y of waste generated to the degree l have determined to be econumlcolly psacncabie and that l have <br />s the present and future threat to human lire and the environment; Oh. If I am a small quantity generator, I <br />- aluThpdthal is available to me that lean allortl. <br />pA�!My�lhi m theeuthor ty ro bind Custn ner, that the forgo ng dear pCons o! waste and materials are rue and accurate <br />3vaw7epYlslfans, flndthat Customer shall abide and be bound by the Standard Terms and Conditions on the reverse <br />Date Driver SkInaUL,, Date <br />Lydia Baker, EHS <br />PR0517826 <br />Page 9 of 12 <br />