Laserfiche WebLink
ASBURY ENVITtONMENTAL SERVICES <br /> 1300 S.SANTA EE AVENUE -' COMPTON.CAI IFORNIA 90221 (310)886 1400 <br /> EPA#CAD028277036 <br /> DIXON UNION CITY CHICO FRESNO <br /> 800-727-2879 888-603-8844 800-733-9043 866-994-6937 <br /> DATE ONETIME PICK UP 7 YES or ONO <br /> CUSTOMER RESIDENCE C YES or r NO <br /> BILLING ADDRESS CONTRACT CUSTOMER L3 YES or❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA _ _ _ AMOUNT _ <br /> JOB SITE ADDRESS CHECK NUMBER <br /> PO.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> -- — —(AMOUNTt <br /> NOTES'. COMMODITY <br /> HALIDES PPM. <br /> NON RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS)STATE CODE 221 <br /> -NO PLACARDS REQUIRED' <br /> J NON-RCRA HAZARDOUS WASTE.LIQUID(ETHYLENE GLYCOL.SOLUTIONS)STATF CODF <br /> -NO PLACARDS OR MARKINGS REQUIRED` NEXT SERVICE DATE <br /> OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. NO.OF GALLONS <br /> DRIVER TRUCK NO.8 RT. <br /> USED OIL AND GASOLINE FILTERS <br /> SA RECYCLING, 33210 Western Avenue,Union City.CA 94567 1-510-487-9277 <br /> —: ALTERNATE FACILITY <br /> DESIGNATED TSDF: ASBURY ENVIRONMENTAL SERVICES•2549 Scot Avenue•Chico,CA 95928•CAL000827844 <br /> ASBURY ENVIRONMENTAL SERVICES-CHICO Il,LLC•1618 W.5th St.,Chico,CA 95928•CAD980694103•(800)733-9043 <br /> '— ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr..Fortuna,CA 95540•CALM256136•(800)133-9043 <br /> _ BAKERSFIELD TRANSFER INC. •1620 E.Brundage Ln.•Bakersfield.CA 93307•CAL000282598•(661)377-0308 <br /> D/K DIXON•7300 Chevron Way•Di.on.CA 95620•CAT080012602•(707)693-6008 <br /> DEMENNO/KERDOON•20DO N.Alameda Street•Compton.CA 90222•CAT080013352•(310)537-7100 <br /> EVERGREEN ENV.•4139 N.Valentine Ave.•Fresno,CA 93122•CAD982446BW•(510)795-4400 <br /> RAMOS ENVIRONMENTAL•1515 S.River Road•W.Sacramento.CA 95691•CAD044003556•(916)371-5747 <br /> WORLD OIL-SAN JOAQUIN,LLC•14287 E.Manning Ave.•Padier,CA 93648•CAL000102751•(559)498-0240 <br /> ALTERNATE FACILITY <br /> USED OIL.USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to cattily That the a ow named ar k:ies are property c1asaArodpp <br /> described.packaged.med <br /> ark <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO;KERDOON THE a,kib W antl m coni <br /> are proper <br /> condition for transportation.accdrdmg o the akcaote reguiatIons of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Dii tined Or 1, la;:o- <br /> _ r <br /> -1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE.THAT THE TOTAL HALIDES ARE LESS THAN 1000 PP.M-: X 's <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY PC B* 1AT <br /> . -�I;S, R SKwalus tE <br /> •1 FURTHER AGREE TO ACCEPT THE AOOI TIONAL CHARGES FOR LEGAL X W/rf <br /> DISPOSAL IF THIS WASTE IS OVER 1000 PPM TOTAL HALIDES.OR <br /> CONTAINS ANY P.C.BS. ara�T NAtK <br /> RECEIVE© <br /> FEB 18 2014 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br />