Laserfiche WebLink
FORM NO. AES003 <br />SERVICE ORDER <br />No. N 607843 <br />ASBURY ENVIRONMENTAL SERVICES <br />1300 S. SANTA FE AVENUE ❑ COMPTON, CALIFORNIA 90221 ❑ (310) 886-3400 <br />SAN DIEGO OFFICE NORTHERN CALIFORNIA <br />1-800-748-5744 EPA CAD028277036 1-800-727-2879 <br />DATE ion <br />- IE 0,i <br />CUSTOM ER <br />BILLING ADDRESS <br />;7" --i r ,PHONE rt i <br />CUSTOMER EPA # I'T"i 1. i-. (', �.` i:f .; i l l c U1 <br />JOB SITE ADDRESS <br />CROSS STREETS <br />NOTES: <br />L/ NON-RCRA HAZARDOUS WASTE, LIQUID (USED OIUMIXED OILS) STATE CODE 221 <br />NO PLACARDS REQUIRED* <br />ONETIME PICK UP DYES or Ll No <br />RESIDENCE ❑ YES or �/NO <br />CONTRACT CUSTOMER P'YES or ❑ NO <br />PLEASE PAY FROM THIS <br />SERVICE ORDER <br />CUSTOMER NUMBER ) G' /-I /'(j/ <br />AMOUNT <br />CHECK NUMBER - ) _ j -I <br />P.O. NUMBER <br />CASH RECEIVED <br />(AMOUNT) <br />COMMODITYlr! ' <br />r <br />HALIDES-^`�fl: P.P.M. <br />❑ NON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) STATE CODE" 133 <br />*NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br />❑ OTHER _ <br />MANIFEST NO. <br />DRIVER <br />❑ NON HAZARDOUS DRAINED USED OIL <br />❑ COMMERCIAL FILTER RECYCLING, 33210 Western Avenue, Union City, CA, 510-487-9277 <br />❑ ALTERNATE FACILITY <br />DRUMS <br />DRUM SIZE <br />NO. OF GALLONS <br />_A. 73 <br />TRUCK NO. & RT <br />-7C�n' /J 7 <br />DESIGNATED TSDF: ❑ <br />ALVISO INDEPENDENT OIL- 5002 Archer Street • Alviso, CA 95502 • CAL000161743 . (510) 476-1740 <br />❑ <br />BAYSIDE OIL II, INC. • 210 Encinal Street • Santa Cruz, CA 95060 • CAD088838222 • (408) 427-3778 <br />❑ <br />EVERGREEN ENV.. 4139 N. Valentine Ave.. Fresno, CA 93722. CA0982446882. (510) 795-4400 <br />❑ <br />DEMENNO/KERDOON • 2000 N. Alameda Street • Compton. CA 90222 • CAT080013352 • (310) 537-7100 <br />❑/D/K <br />DIXON . 7300 Chevron Way. Dixon, CA 95620. CAT080012602. (707) 693-6008 <br />O <br />RAMOS ENVIRONMENTAL . 1515 S. River Road . W. Sacramento, CA 95691 . CAD044003556 . (916) 371-5747 <br />❑ <br />ASBURY ENVIRONMENTAL SERVICES • 2549 Scott Avenue • Chico, CA 95928 • CAL000827844 <br />❑ <br />ALTERNATE FACILITY <br />USED OIL, USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is tolabelecertify [hat the above named articles are properly classified, described, packaged, marked <br />RECYCLED AT OUR SISTER COMPANY DEM ENNO/KERDOON THE and d, and are in proper condition for transportation, according to the applicable regulations of <br />LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <br />*1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY -- _ - ' <br />OTHER WASTE, THAT THE TOTAL HALIDES ARE LESS THAN IWO P.P.M : X !�- lr :'� G�7 <br />AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATURE DATE <br />*I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br />DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M. TOTAL HALIDES, OR <br />CONTAINS ANY P.C.S'S. <br />