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FORM NO.AES003 <br /> SERVICE ORDER <br /> No. N 9028848 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE n COMPTON,CALIFORNIA 90221 (310(886 3400 <br /> EPA#CAD028277036 <br /> DIXON UNION CITY CHICO FRESNO <br /> 800-727-2879 888-603-8844 800-733-9043 866-994-6937 <br /> DATE ` ONE TIME PI K UP ❑YES or ❑NO <br /> \� <br /> CUSTOMER L �"�- ` 1 { \ �� P RESIDEN E ❑YES or ❑ NO <br /> BILLING ADDRESS ON ACI C TOMER C).YES or ❑ NO <br /> i <br /> P A P Y FROM <br /> ER 1 E ORDS <br /> r <br /> PHONE + 1 l V• '� y (CONTACT S ER <br /> CUSTOMER EPA# Com_ ' —� MOUNT <br /> JOB SITE ADDRESS %S�-� �' �-� CHECK N BER <br /> cr_ 'L t `J C ` � �- _ BER <br /> CROSS STREETS CASH E CEIVED t ��o NT) <br /> MMODITY <br /> NOTES: <br /> HALIDES P.Rt <br /> U NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIUMIXED OILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE NEXT SERVICE DATE <br /> *NO PLACARDS OR MARKINGS REQUIRED* <br /> DRUMS DtRUM SIZE <br /> I OTHER NO.OF GALLONS i ZP <br /> MANIFEST NO. <br /> _..•� TRUCK NO.&RT. Q � <br /> )RIVER <br /> USED OIL AND GASOLINE FILTERS <br /> SA RECYCLING, 33210 Western Avenue, Union City,CA 94587 1-510-487-9277 <br /> ALTERNATE FACILITY <br /> SIGNATED TSDF: ❑ ASBURY ENVIRONMENTAL SERVICES• 2549 Scot Avenue•Chico, St 95928•CAL000827844 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 DinsmoreW. tDStFortulna,CA 95540• CALL930256136•(800)733- <br /> ❑ ASBURY ENVIRONMENT* <br /> ❑ BAKERSFIELD TRANSFER INN/a• Dixon,1nE. Brundage Ln.o CA 95620• CAT080012602tl (707)693-6008 <br /> L000282598• (661)377-030 <br /> ❑,• D/K DIXON • 7300 Chevron yo Compton, o CA <br /> 10) <br /> DEMENNO/KERDON ° 2NOv Valentine Ave.da esno,CA 93722*CAD9824468820o13352 o 3(510)795 <br /> O 90222 4400 537-7100 <br /> Q -5747 <br /> EVERGREEN ENV. • 4139 <br /> ❑ <br /> RAP16)371 <br /> ENVIRONMENTAL• 1515 S.�River Mann g Aver • Parl er CA 93648 CAL000 02751.1(559)498-0240 <br /> ❑ WORLD OIL-SAN JOAQUIN, LLC <br /> ❑ ALTERNATE FACILITY <br /> REAMSWASTE STREAMS ARE ThAR� is is to certify that the above named articles are properly classified, described.aediU <br /> OIL, USED ANTIFREEZE <br /> AND OILY COMPANY DTEMENNO KERDOON THE and labeled, and are in proper condition for transportation, according to the apP <br /> CLED AT OUR the Department�ofTransportation.. <br /> EST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. <br /> EBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> STE, THAT THE TOTAL HALIDES ARE LESBSTHAN 1000 PPM.; CUSTOMER SIGNATURE <br /> I WA __,,tea.kin-r rnAITAIN ANY PC. ' - <br />