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09/17/2003 WED 10:19 FAX 004/00
<br /> •
<br /> IP - --� SERVICt ORDS
<br /> AUG 8 2003 s
<br /> M► NO. N 4,20%6
<br /> ASBURY ENVIRONMENTAL SERVICES
<br /> 100'NORTH AIAMEDA STREET ❑ COMP ION, CAIJFORNLA 90ZZ2❑ (3101886-34 00
<br /> SAN DIFGO OFFICE NORTHERN CALIFORNIA
<br /> 1.-800-748-5744 EPA W028277036 I H,4?Q7,2'7-Z$7,9,• ;,,. ,,. ;.
<br /> 1`800.<933-9194
<br /> DATE
<br /> ONETfME PICK U •'- OY�S`brh I
<br /> RESIDENT d'YES.br' c
<br /> BILLING ADDRESS '/00 ? � CONTRACT GUSI'OMEA 1;7 YES or I
<br /> PHONE y r CONTACT CUSTOMER NUMBER
<br /> CUSTOMER EPA'# f7 'O-yyi� r��r AMOUNT
<br /> JOB.SITE-ADDRESS CHECK'NUM6ER
<br /> — _ P.O.NUMBER
<br /> CROS S`IkREE7S. CASH RECEIVED
<br /> (AMOUNT)
<br /> NOTES: COMMODITY �^2f
<br /> HALIDESPPM.
<br /> NON-RCRA HAZARDOUS WASTE;LIQUID(USED OILlMIXFD bILS)STATE CODE,_" _
<br /> *NO PLACARDS 6EQUfRED°
<br /> ❑ NON-RCRA.HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE __
<br /> *NO-
<br /> PLACARDS•OR MARKINGS REQUIRED* NEXT SERVICE DATE
<br /> 0 OTHER DRUMS DRUM SIZE
<br /> MANIFEST N0- 5NO.OF GALLONS
<br /> DRIVER TRUCK NO.&RT.
<br /> ❑ NON HAZARDOUS DRAINED USED OIL FILTER
<br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union CIN CA,510-467-9277
<br /> n ALTERNATE FACILITY,
<br /> DESIGNATED TSDF: C] ALVISO INDEPENDENT OIL-5002 Archac§tree7'•Alvis ,QA;9 5Q2 ` )$1,743,•,(408)262.1360
<br /> ❑ SAYSID6 OIL II;'INC. 21'0 Enclnal
<br /> -Street Santa Cf61z,CA859Fa0•.CAD„ , 1, (408)427 3778
<br /> lA,..,,.,,, ,
<br /> ❑ ARTESIAN OIL RE90VERY INC.-2306.Magnolia,Street-.Oakland,CA'841, '•: AL000233905-(510)939.4234
<br /> ❑ DeMENNO/KER©dQN--2000 N.AIft!reda Street•Cbmpton,.C*AD222�1ai�, ,0013352-(310)537.7100
<br /> ElOCS-3255 N.Marks Street.•Fresno,CA 93722•CAD98067364 ,',(5 9),455`5486
<br /> A RAMOS ENVIRONMENTAL-15j'5�,P�iver,Rbad-1N.Sacram6hf$,;.'.0 x ff5t�j'�L`Abaaoo3456-(816)371-5747
<br /> ❑ ASBURY ENVIRO`NMENrAt-SERZICCS 2549 Sc6tt Avenue Chico;�A�'95928' "DAL 000927944
<br /> ❑ ALTERNATE FACILITY
<br /> USED 011,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE Th1a la 10 certl that ltle-a0ov n Metl articles arc rocrl cldssiticd,tlC3CYibetl, aCHaged,marl
<br /> RECYCLED AT OUP S.ISTEA COMPANY DEMENNO/KERp0gN'.T,HE P, p p Y 6oebla re ul,mari
<br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNTIEP'3TATES. and'IaQ0Ibf1;e11tl'3r6 in'prop'er-,canditr66 for trarisportatlon;according to the'app" g
<br /> the Department of Tr3nspo/tatl0ftt '
<br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH—ANY \,'
<br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN low RPM.; X
<br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S., CUSTOMER SIGNATL(RE DATE
<br /> *1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X
<br /> DISPOSAL IF THIS WASTE IS OVER 1000 RRM•TOTAL,HALIDES, OR -
<br /> CONTAINS ANY RC.B'S. PRINT NAME
<br />
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