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FORM NO.AES003 <br /> SERVICE ORDER <br /> No. N 650662 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE. Q COMPTON,CALIFORNIA 90221 .❑ (31.0):886-3400 <br /> DIXON UNION CITY <br /> 1-800-727-2879 EPA CAD028277036 1-888-603-8844 <br /> DATE ONE TIME PICKUP DYES or ❑NO <br /> CUSTOMER RESIDENCE ❑ YES or ❑ NO <br /> BILLING ADDRESS CONTRACT CUSTOMER ❑ YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE 'S "- -^ CONTACT CUSTOMER NUMBER <br /> r <br /> CUSTOMER EPA . AMOUNT <br /> JOB SITE ADDRESS CHECKNUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> -)TES: COMMODITY <br /> HALIDES - PPM. <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILIMIXED OILS).STATE CODE 221 <br /> • *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE:DATE <br /> ❑ OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. .T�. 3 P',' 1 3`J I f'r LL1 1 NO.OF GALLONS7r.r <br /> . _ 1 <br /> i <br /> DRIVER TRUCK NO.&FIT. <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue, Union City,CA,510-487-9277 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDF:. ❑ ALVISO INDEPENDENT OIL-5002 Archer Street•Alviso,CA 95502•CAL000161743.(510)476-1740 <br /> ❑ BAYSIDE'OIL II,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(831( 427-3773 <br /> ❑ EVERGREEN ENV.•4139 N_-Valentine Ave.•Fresno,CA 93722• CAD982446882- (510)795-4400 <br /> ❑ DEMENNO/KERDOON •2000 N.Alameda Street•Compton.CA 90222•CAT080013352•(310)537-7100 <br /> CV DIK DIXON*7300 Chevron Way•Dixon,CA 95620•CAT080012602•(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S.River Road .W.Sacramento,CA 95691 .CAD044003556 .(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ALTERNATE FACILITY <br /> "^FD OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE <br /> YCLED AT OUR SISTER COMPANY DEMENNOIKERDOON THE. .This is to certify that the above named articles are properly classified,cordgto tscribed,packaged, marked <br /> ,GEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. arid labeled,and are in proper condition for transportation, according to the applicable regulations of <br /> the Department of Transportation. <br /> 'I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THATTHE TOTAL HALIDES ARE LESS THAN 1000 PPM.; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.S'S.. CUSTOMER SIGNATURE DATE <br /> •I FURTHER AGREE TD 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.B'S PRINT NAME' <br />