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FOR SERVICE CALL "as...0 SERVICE ORDER `41.0/ DIXON OFFICE 1-800-7-ASBt1PtSERVICE ORDER NO. 2 UNION CITY OFFICE r� = _�- � fya Ri(Ei:Lid 1-886-603-8844 o ASBURY ENVIRONMENTAL SERVICES s 1300 SOUTH SANTA FE. COMPTON. CA 90221 H 1-310-888-3400 c MAXIM CRAtt E:: Wf)l .^: S TRANSPORTER EPA#CAD028277036 MAXIM CRANE WORKS P 2373 MARIPUSA ROAD F'Q BOX 999 D o STOCKTON. CA 95205 LA F0RT'F. TX 77572 (209) 464-1'635 (281.) 471-1.766 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES MAX602 MUST GFT" 9 5 GATFA Y kco=s;:i.EI DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# MANIFEST# Si/25/2009 8/24/2009 CAD98235694'1. PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL N/R L NON--RCRA LIQUID PER DRUM 3 IFS INSURANCE F-ULL. SURCHFlRf::F i. I N/R S NUN-RC'RA SOLID FTR DRUM 6 6 DRUIS OF- SOLIDS -' 2 55G LIQUID TAR -• 1. 30G L IOU1:D T R -• NO EPLAC .F'F,TS Cr :Iss Streets: TOTAL _I CASH RECD: CHECK It PLEASE PAY FROM THIS SERVICE ORDER WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS)'NO PLACARDS REQUIRED- STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)-NO PLACARDS REQUIRED" STATE CODE_ OTHER: DESIGNATED TSDF. ALTERNATE TSDF: CFR: 33210 Western Avenue, Union City,CA 94587(510)487-9277 DRUMS PN: EMPTYDRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION PLEASE CHECK THE APPROPRIATE BOX This is to ceMry that the waaN deacribee aYwv+is progeny claafitied,docribed,p+vkagee,marted ane labeled,and is In proper condilinn rw veneporcan......luing la applicame Sta!e and federal regulations.9y signing below l alw hereby cMey that: (Waste oil generator/customer MUST check ONE of the following three boxes) G en I nava nM....deny of the wsm described above with any uther haaarecus waste,the total halide comarl if LESS than 1,000 Ppm,and Ibe waste does not contam any PCBs.1 have ompliad wile Me reauiremanR or me avpfoWe calimrnia uaea ou m,n+gement re9,Daion:Po eaermine mis Is true.I agroe m aCcepl me additional charges tot the disposal of this waste it Ne Mlormabon I nave provided about Mia waste f incortect 0 0311 haver not mixed any of Me waste described above with any other hazardous waste,the total halide content,.GREATER Man 1,000 ppm,and the waste dos nm comain any PCBs I have provided pope!dxurdentanm to sapidity Environmental Services to rebut Me presumption that this waste was mixed with Other hazndous wesle.t agree 1.accept Ma uMnronal cNrgee ,.,.a disposal of this watt.If the information 1 have povlded about Mil waste is incorrect 0 Yd1 This wail.is from a lank which offers..at.dl from h.u..d.d-dr,41-youna1f DWI anchor Cmd.h. .t y...mdc ama0 guanti i generator(CESQG)sources.io 1.,deal of my knowledge.Me only wash,all confined in my DWI CESW collection lank is spicy from DIY color CESQG sources.I have not mixed the waste oil with any other hazardous waste or waste ml from other sources,l agree to accept Me Additional changes for deposal of Nis.....If Me information I have provided about this waste is incMect (All generators/customers MUST read the following text and check the associated box.) ❑NI If I am a large quantity gan...to'I certdy that I have a program In place to reduce the volume and toxicity of waste generated ro the degree i have determined to he econommally precticable and that I have selected the pnctic0ba Method of treatment,storage,or disposal currently avaifba to me which minum1*5 the present and future threat to human bre and the environment,Or,111 am a small qumtity gen—Mir,I have made a good faith eMon to Minimize my waste generation end select the best waste management method that is ava labM to the test I can afford Customer Signature Date Driver Signature Date Print Name Print Drivers Name