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FORM NO. AES003 <br />SERVICE ORDER <br />No. N 634999 <br />ASBURY ENVIRONMENTAL SERVICES <br />1300 S. SANTA FE AVENUE o COMPTON, CALIFORNIA 90221 n {310) 886-3400 <br />DIXON -1 UNION CITY <br />1-800-727-2879 EPA CAD029277036 14)1&603-8844 <br />DATE e- �' �` ONETIME PICK UP f7 YES or ❑ NO <br />CUSTOMER .�� y' r �,rr/.r� `~' I RESIDENCE ❑ YES or ❑ NO <br />BILLING ADDRESS CONTRACT CUSTOMER ❑ YES or 0 NO <br />PLEASE PAY FROM THIS <br />i SERVICE ORDER <br />PHONE .3r) tr �fp" ,�.. S CONTACT i' .! 'tea ,��) CUSTOMER NUMBER <br />CUSTOMER EPA It �+� t' r c'r f�' f r AMOUNT <br />JOB SITE ADDRESSCHECK NUMBER <br />P.O, NUMBER <br />CROSS STREETS CASH RECEIVED <br />{AMOUNT) <br />S: COMMODITY — * / � r:, <br />L HALIDES i /.r a P.P.M. <br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXED OILS) STATE CODE 221 <br />*NO PLACARDS REQUIRED' <br />❑ NON-RCRA HAZARDOUS WASTE, LIOUID (ETHYLENE: GLYCOL SOLUTIONS) STATE CODE 133 <br />*NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br />❑ OTHER DRUMS DRUM SIZE <br />MANIFEST NO. r r;_=, q 4�� �; ''� ;�� -/ j NO. OF GALLONS 4t�/ <br />DRIVER o fr„ �- TRUCK NO. & HT <br />D NON HAZARDOUS DRAINED USED OIL FILTER <br />U COMMERCIAL FILTER RECYCLING, 33210 Western Avenue, Union City, CA, 510.487-9277 I <br />❑ ALTERNATE FACILITY <br />DESIGNATED TSDF: 1-) ALVISO INDEPENDENT OIL - S002 Archer Street • Alviso, CA 95502 • CAL000161743 * (510) 476-1740 <br />11 BAYSIDE OIL It, INC. • 210 Encinal Street • Sante Cruz, CA 95060 • CAD088838222 • (831) 427.3773 <br />O EVERGREEN ENV. • 4139 N Valentine Ave • Fresno. CA 93722 * CAD982446862 * (510) 795-4400 <br />C,�L DEMENNO/KERDOON - 2000 N. Alameda Street • Compton. CA 90222 . CAT080013352 • (310) 537-7100 <br />C] D/K DIXON a 7300 Chevron Way a Dixon, CA 95620 * CAT080012602 * (707) 693-6008 <br />❑ RAMOS ENVIRONMENTAL . 1515 S. Rr4er Road . W Sacramento, CA 95691 . CAD044003556 .(916) 371-5747 <br />❑ ASBURY ENVIRONMENTAL SERVICES • 2549 Scott Avenue • Chico, CA 95928 • CAL000827844 <br />❑ ALTERNATE FACILITY <br />t" 'L, USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to certify that the above named arm** are property classified, described, packaged, marked <br />.ED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled. and are in proper condition for transportation, accordthg to the ap011cable regulations of <br />Ir-,-dST RECYCLER 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 1Goo PPM.; X <br />AND THAT THE WASTE DOFS NOT CONTAIN ANY PC B'S.. CUSTOMER SIGNATURE DATE <br />'I FUR I HER 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 P.C. B'S PRINT NAME <br />