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Oct. 8. 2012 4:07PM No, 3973 P. 3
<br /> FOR'SERVICE GALL! . .., .SERVICE ORDER Fowtiuo.AEsoo+-elx>:vmon
<br /> DIXON,OFFICE ••
<br /> 1-800-7-ASBURY' SERVICE ORDER NO. _
<br /> UNION CITY OFFICE r, ,r,., . T,,, —tea , "•' .
<br /> 1-888,-SM-8844 . a ''pa�•`�(3gi - • 'rs N1475390
<br /> e•'Y 4,
<br /> CHICO
<br /> -800433
<br /> .. ASBURY ENVIRONMENTAL SERVICES
<br /> 1300 SOUTH SANTA FE,COMPTON,CA 90221
<br /> in MAYJM CRANEa�ORKS 1'-310-686-3460 ,.. . MAXIM CANE WbRKS-PARENT
<br /> P 2373 MARIPOSA:ROAU _ TRANSPORTER EPA#CAD028217036 ,, PO LOX M .
<br /> E:
<br /> STOCKTON,CA 95205LIE FORTE,TX 77572
<br /> o (911 .452-9981
<br /> Oil 471,17M
<br /> CUSTOMER# .PURCHASE ORDER# ROUTE#. . R CK#, CONTACTNAME QRDeR TAKIEN SY I HALIDES
<br /> IvTAXe02i 2 CHEDU!ED
<br /> ATEREQUIRED PATF ENTERED NEXT SERVICE DATE CUSTOMER EPA# MANIFESTO
<br /> 711812012, 12. CAD982358941
<br /> `?8 -1/.?
<br /> s TJX'✓..:.
<br /> ' PART# 'DESCRIPTION QTY . UNIT PRICE QTYP/U TOTAL
<br /> WOSC USED OILSERVICE'CHARGE i . C`��
<br /> WO. '., USED OIL 1:MIXED OILS b54 SRO .,
<br /> .Oros 8traets: . '
<br /> TOTAL
<br /> CASH RECO: • .CHECK# - PLEASE PAY FROM THIS SERVICE ORDER•
<br /> WASTE DISPOSAL INFORMATION
<br /> • NON-RCRA NAZARDOOUs WASTE,LIQUID(USED OILIMIXED OILS)"NO PLACARDS REQUIRED' :STATE CODE 221
<br /> NONdtCRAHAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)'NO PLACARDS REQUIRED' STATE CCDE_
<br /> '0ESlSNATEDTSDFMm0S ERAIRONVENTAL.15 66.1IVERVRD,Vi.SACkAMENTD.CAg3A41,(816)371-s 4 < D64M1 86'
<br /> ALTERNATE TSOF: T
<br /> SA RECYCLING: 33210*es{ern Avenue,Unlon Clty,CA 04587 1-510467=4277
<br /> ORUMSPIU: ._ EMPTYDRUMS: FACILITY; BBC
<br /> GENERATOR WASTE CERTIFICATION
<br /> PLEASE CHECK THE APPROPRIATE BOX '
<br /> This bocogfy that lhews.teGudbed above La propwlycl...Man,d.aulbod:.packsp.d.nuked end l abelec.ano h lhptnpercondidpn Am uanspadadm,aecudnp Oplleaato SUR '
<br /> .
<br /> And Ward ns uhtimo:Syaipninp bot.l also heron,caddy(hot "
<br /> (Waste oil generator/customer MUST check ONE of the following three boxes)
<br /> 1NI LI hes..ml mixed Any of the waaw deacdbael abwo with any other hazardous waeU;Ihe total pada•con tent is LESS than 1,11110 ppm,and the rrvssl•do m not aenhin a w ecas.l how.
<br /> 41Ied with Ne requlrema nls of the eppllc Aute CoIlloml a wsd oll management ryBuUtlon,Is delarMn a W.la We.l agae to ani"pl the additional ehupN for the dlapasal of this wooto
<br /> If ote Wpmu8 on l hive provide d.b bbl Nl a wNle is income l -
<br /> '0/=)Lha,•nth mhed My of rhe weals dawned abaya 911A eny oNUrhsnrdaue'wSeR,LIR Ism IUIIds,wflRM N ORRAT@R lha i 1,000 ppm,And Ihe",is dean An conlabt any PCBs
<br /> have praiiMdprgwr daeumenuum l.(ubury FnvieenmmRl Seeviees lurebul du pr.furryailen iherlN[WarR eq,[mlkad WIN dneflluardouewule.l aprcoroacmpl the eaadasa ug•a
<br /> fur thetliapoaa el Yds wztslydw lnfpmaUm lhsys proaOW oleallhis wierefa ingOMCI
<br /> DdJIThRwasle lefroma Unk whish d0totnaw"gq.ellfrom howepald•yloll-yoursalPlDIYisn&ormnd'Geuaby exempt small quAn111y BonerglarlCE5Q0)aouT,N.Tq thebyt efmy, „
<br /> kgoMedgq lM enly weeRetiwnt�in.d Yt WYl;di CEntKi cgliecdon tankU[oUy-f{o!n OlYanNw CESQC•earn...l have nm IKd this wale all with any Mar hazardous wasU ar
<br /> wuta en'lran eqv m.Fla9 ser aee.pl'Ige addiBenal ehagea'rordlayeaalNthti tiAAlsti Nelgrdml•donlh•4•prvHEedaeaN this w+stn l:lncarnd
<br /> (AR generators/cu#9niers MUSf.riead;the following text and 6edc t_he fated bax.}
<br /> fyy�"I lrl•m alery•quendy g•nerilw lc•mly mulnana prgr;m lnplap lClade[oth.ymuma+nd leYplYN .at deAUalld to p 1 avd.Mrmlri be eelnnmloRly �.
<br /> 600cam,And,IhMlnWe am..Wd Na2`0
<br /> e nNlhpd at ViaNlanL SlwadW wdapeillwncndy••+dant t Nch mNm In p • alld fulurc thfxalbnurtNe Inland `
<br /> IM'anw,e mNli Or,fit am.apW]WsRk•LMYriflalbYfrlodfYlh bled le dlni[mhRmyMaNgMMlldn apd�elAid be anepom•elnlelllgl thNli Walukla
<br /> I.
<br /> Cu .merSi¢netura.' at `• -Dt1've .•�Date... . r
<br /> Print Name'... . . :, T-. ... , .. . . . . ... •VPTintDriY4rs Hli ...
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