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— z� SERVICE ORDER N0. <br /> ASBURY ENVIRON <br /> 1300 SOUTH SANTA N ENTAL SERVICES <br /> 1-310.986 X00 TON,CA 90221 <br /> TRANSPORTER EPA#CAD028277036 <br /> # PURCHASE ORDER# ROUTE# <br /> 'coyan <br /> TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES <br /> DATE ENTERED <br /> NTERED NEXT SERVICE DATE <br /> CUSTOMER EPA# MANIFEST# 'NG <br /> E <br /> DESCRIPTION <br /> QTY UNIT PRICE QTY PIU TOTAL <br /> G <br /> TOTAL <br /> ZEC'D: CHECK# PLEASE PAY FROM THIS SERVICE ORDER <br /> WASTE DISPOSAL INFORMATION STATE CODE 221 <br /> )N-RCRA HAZARDOUS WASTE, LIQUID(USED OIUMIXED OILS)*NO PLACARDS REQUIRED' <br /> UID(ETHYLENE GLYCOL SOLUTIONS)'NO PLACARDS REQUIRED' STATE CODE <br /> )N-RCRA HAZARDOUS WASTE, LIQ <br /> -HER: <br /> :SIGNATED TSDF: <br /> TERNATE TSDF: CA 94587 1-510-487-9277 <br /> RECYCLING: 3 <br /> t 3210 Western Avenue, Union City, gSC�_ <br /> FACILITY: <br /> EMPTY DRUMS:_— WASTE CERTIFICATION <br /> . 11 <br /> PN: GENERATOR <br /> PLEASE CHECK THE <br /> APPROPRIATE BOX Ration,accordingtoapPlicableState <br /> described,Packaged.marked and labeled,and is in proper condition for transpo <br /> classified, three bores) <br /> anythat the waste described above is properly certify that: US,i.Check ONE of the following contain pcgs.l have <br /> ertify signing below I also hereby homer M <br /> ulations. BY sig ante o generator/cu 000 ppm,and the waste does for the disposal of this wast <br /> it reg �� it t the additional charges <br /> with any other hazardous waste, <br /> the total halide content is LESS t agree to accept <br /> of the waste described above <br /> management regulations to determine this Is true. a9 PCBs <br /> ve not mixed any the apPthan 1,000 ppm,and the waste does not i e additional ch <br /> licable California used oil manag to accept tiri <br /> with the requirements of waste is incorrectwaste.)agree <br /> I have provided about thiste,the total with other hazardous <br /> rmation other hazardous'b tion that this waste was mix ed GREATER <br /> described above with any CESQGI sources.T°the best o1 my <br /> ¢wasted generator t mixed any°f to Asbury Environmental Services to rebut the t small quantity g other hazardous waste o <br /> ve no umentation Provided about this waste is incorrect y exemp <br /> roper doc ¢information I have p ply)an conditional) .xed this waste oil with any <br /> ,ided proper <br /> waste if the do_lt_yourself'( sources.I have not m waste is incorrect <br /> sposal of from household' from DIY andlor CESQG I have provided about this Ss�at^�boX <br /> collects waste oil check the ed 1 <br /> tank which ply)CESQG collection tank is Soley and fined to be economic <br /> to is from a es for disposal of this waste if the infor ing tem` determ nlifa at s was ste oil contained in pt the follo the degree 1 have v <br /> f¢ the only wa accept the additional charges MUST read generated to 85ent and future threat to human a ail: <br /> s l agree to omers °f waste g lzes the Pr ent method <br /> other source ¢and toxicity hick minim aste management <br /> from (All generators/CVS a the volum est W <br /> ram in place to reduc oral currently available to me"' select the b <br /> eneratol 1 certify that I have a program <br /> storage,or disp waste generation and <br /> am a large quantity 9 practicable method of treatment,goo <br /> faith effort to minrrr,�ze my <br /> Or,if I am a small quantity generator,I have made a 9 <br /> ale and that I have selected the <br /> •onment; nature <br /> at I can afford. privet S�9 <br />