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• • FORM NO.AES003 <br /> SERVICE ORDER <br /> NO CHARGE <br /> == No. N 637120 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE o COMPTON,CALIFORNIA 90221 0 (310) 886-3400 <br /> DIXON UNION CITY <br /> 1-800.727-2879 ] EPA CAD028277036 1-888-603-8844 <br /> / <br /> DATE - z O C7 ONETIME PICK UP OYES or ONO <br /> r' / <br /> CUSTOMER R/� c —it 7`4r1" Z, .' RESIDENCE ❑ YES or ❑ NO <br /> o� <br /> BILLING ADDRESS CONTRACT CUSTOMER O YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDEf }O� OO - <br /> PHONE.�`7�O— TZ C-2 /CONTACT <br /> O CUSTOMER NUMBER �I II``ff�� <br /> CUSTOMER EPA# C. -�fzGG CP 2 L 9.7 3 AMOUNT <br /> JOB SITE ADDRESSy� ���'�'G'r--g 7 CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> _ <br /> NOTES: COMMODITY _o/lam <br /> HALIDES � ' 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 /> MANIFEST NO. NO./C J S�. NO.OF GALLONS <br /> DRIVER S l f TRUCK NO.&HT �ZG n <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: ❑ ALVISO INDEPENDENT OIL-5002 Archer Street•Alviso,CA 95502-CAL000161743.(510)476.1740 <br /> ❑ BAYSIDE OIL II,INC.-210 Encinal Street-Santa Crez,CA 95060-CAD088838222.(831)4273773 <br /> ❑ EVERGREEN ENV. .4139 N. Valentine Ave. .Fresno.CA 93722.CA0982446882.(510) 795-4400 <br /> ED DEMENNO/KERDOON •2000 N.Alameda Street•Compton.CA 90222-CAT080013352-(310)537.7100 <br /> ❑ DIK DIXON.7300 Chevron Way.Dixon,CA 95620.CAT080012602.(707)693.6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S.Rifer Road .W.Sacramento,CA 95691.CA0044003556 .(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ALTERNATE FACILITY <br /> ED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that me at n sd ani es a properly classified,described,packaged,m reed <br /> :CYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and are in pro r tlition 1 Ira ort Fon,according to the applicable regulat�ns of <br /> RGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transpo I / <br /> iEREBY CERTIFY THAT 1 HAVE NOT MIXED THIS WASTE WITH ANY ! V/' <br /> HER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X / I I <br /> 0 THAT THE WASTE DOES NOT CONTAIN ANY PC B'S- CUSTOMER SIGNATURE DATE <br /> ;URTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> 'POSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> NTAINS ANY PCB'S, PRINT NAME <br />