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FORM NO.AES003 <br /> .0 4 <br /> SERVICE ORDER <br /> NO. N4 <br /> ASBURY ENVIRONMENTAL. SERVICES <br /> 1300 S. SANTA FE AVENUE o COMPTON,CALIFORNIA 90221 c7 (310) 886-3400 <br /> NORTHERN CALIFORN <br /> SAN DIEGO OFFICEIA <br /> 1-600-748-5744 EPA CAD028277036 1-800-727-2879 <br /> ONE TIME PICK UP ❑YES or ❑NO <br /> DATE <br /> RESIDENCE ❑ YES or ❑ NO <br /> CUSTOMER <br /> CONTRACT CUSTOMER ❑ YES or ❑ NO <br /> BILLING ADDRESS <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> ?HONE CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA tff AMOUNT <br /> JOB SITE ADDRESS CHECK NUMBER <br /> ._ P.O.NUMBER <br /> CASH RECEIVED <br /> CROSS STREETS (AMOUNT) <br /> COMMODITY <br /> NOTES: <br /> HALIDES P.P.M. <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXED OILS)STATE CODE <br /> 221 <br /> *NO PLACARDS REQUIRED* <br /> El NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 NEXT SERVICE DATE <br /> *NO PLACARDS OR MARKINGS REQUIRED* <br /> DRUMS DRUM SIZE <br /> ❑ OTHER <br /> `#.>= NO.OF GALLONS `•'; r` <br /> MANIFEST NO. <br /> TRUCK NO.&RT. <br /> DRIVER <br /> ❑ NON HAZARDOUS 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 11,INC.•210 Encina!Street•Santa Cruz,CA 95060•CAD086838222•(408)427-3778 <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 /> ❑ DIK DIXON•7300 Chevron Way.Dixon,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 is to certify that the above named articles are properly classified, described, packaged, mar <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled, and are In proper condition for transportation, according to the applicable regulation <br /> LARGEST RECYCL€R OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <br /> *1 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 CUSTOMER SIGNATURE DATE <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. <br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR PRINT NAME <br /> CONTAINS ANY PC.B'S. <br />