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/ • _ = • SERVICE ORDER <br /> a <br /> No. N 656773 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 90221 0 1310)886-3400 <br /> DIXON UNION CITY <br /> 1.800-727-2879 EPA CAD028277036 1-888-603-8844 <br /> DATE � �� I '' � / l/ ONETIME PICK UP OYES or ❑NO <br /> CUSTOMER %'n..� /,/� ..y,,,• N.r RESIDENCE ❑ YES or ❑ NO <br /> BILLING ADDRESS _ CONTRACT CUSTOMER ❑ YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE Ir'-7 /F/"1/ CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# r�-/G / Gc.:� t � ) `. .r AMOUNT <br /> JOB SITE ADDRESSfi /' ."C t CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> 'AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES P.P.M. <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED 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 /> MANIFEST NO. r` IC-` NO.OF GALLONS <br /> DRIVER /'ii. TRUCK NO,8 HTS O <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 /> ❑ SAYSIDE OIL 11,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088e38222•(831)427.3773 <br /> ❑ EVERGREEN ENV..4139 N. Valentine Ave. •Fresno,CA 93722.CAD982446882•(510) 795-4400 <br /> E9 DEMENNO/KERDOON •2000 N.Alameda Street•Compton.CA 90222•CAT080013352•(310)537-7100 <br /> ❑ DIK DIXON.7300 Chevron Way.Dbton,CA 95620.CAT080012602•(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S.River Road .W.Sacramento,CA 95691.CAD044003556 .(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 I to cerlM 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 •ondition for transportation,according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of are <br /> q <br /> ITH AN <br /> OTHER WASTE,T'I HEREBY CERTIHAT FY THE TOTAL HALIDES ARE LTHAT I HAVE NOT MED ESS THAN S WASTE 10000 P,M.; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATURE DATE <br /> •1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR X <br /> CONTAINS ANY P.COS. PRINT NAME <br /> L <br />