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• FORM NO. AES003 <br />SERVICE ORDER <br />NO N 607827 <br />ASBURY ENVIRONMENTAL SERVICE!:; <br />1,300 S. SANTA FE AVENUE ❑ COMPTON, CALIFORNIA 90221 ❑ (310) 88 '-3400 <br />.SAN DIEGO OFFICE I'JORTHEF V CALIFORNIA <br />1-800-748-5744 EPA CAD028277036 1 900-727-2879 <br />DATE ! 13 - C) I' ONE "IME PICK UP ❑YES or O <br />CUSTOMER k%f. 'r'E r L=..• ✓ .� t �. . `�_. RESIC ENCE ❑ YES or AO <br />BILLING ADDRESS <br />PHONE'` ?� 5CONTACT� <br />ry C144,.S.. 0 (!�� <br />CUSTOMER EPA �# � � y s, v .� � <br />JOB SITE ADDRESS A-�': {y <br />CROSS STREETS <br />NOTES <br />i !.c <br />CONI RACT CUSTOFOER (/YES or ❑ NO <br />PLEASE PAY'1!=ROM THIS <br />SEF VICE ORDER f ,t <br />CUST OMER NUMBER eel" zc_04 <br />AMOL NT <br />CHEC K NUMBER <br />P.O. N JMBER <br />CASH RECEIVED <br />IF <br />(AMOUNT) <br />COMh IODITY <br />HALIC ES <br />❑ NON=RCRA HAZARDOUS WASTE, LIQUID (USED OILJMIXED OILS) STATE CODE 221 <br />*NO PLACARDS REQUIRED* <br />CVNON-RCRA HAZARDOUS WASTE, LIQUID (ETHYLENE GLYCOL SOLUTIONS) STATE CODE 133 <br />*NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE. <br />❑ OTHER <br />MANIFEI <br />DRIVER <br />❑ NONHAZARDOUS DRAINED USED OIL FILTER <br />❑ COMMERCIAL FILTER RECYCLING, 33210 Western Avenue, Union City, CA, 510-487-9277 <br />❑ ALTERNATE FACILITY <br />DRUM S I:1RUM SIZE <br />NO. 0: GALLONS .t <br />TRU CK , T <br />NO. & R7I t <br />DESIGNATED TSDF: ❑ ALVISO INDEPENDENT OIL - 5002 Archer Street • Alviso, CA 95502 • CAL00011;i1743 • (51)) 476-1740 <br />❑ BAYSIDEE OIL Il, INC. • 210 Encinal Street • Santa Cruz, CA 95060 . CAD088838 322 • (408 427-3778 <br />❑ EVERGREEN ENV.. 4139 N. Valentine Ave. • Fresno, CA 93722 . CAD982A4.6882 • (', 10) 795-4400 <br />❑ OEMEN NO/KERDOON • 2000 N. Alameda Street • Compton, CA 90222 • CATOS,:I013352 • 310) 537-7100 <br />E1.2/11( DIXON . 7300 Chevron Way . Dixon, CA 95620 • CAT080012602 • (707) 691,-6008 <br />RAMOS ENVIRONMENTAL. 1515 S. River Road -W, Sacramento, CA 95691 . I:;AD04400 3556. (916) 371 -5747 <br />❑ ASBUR'Y ENVIRONMENTAL SERVICES • 2549 Scott Avenue • Chico, CA 9592EI • CALOOO 327844 <br />❑ ALTER14ATE FACILITY <br />USED OIL, USED ANTIFREEZE AND OIILY WATER WASTE STREAMS ARE <br />RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE <br />LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. <br />'I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH. ANY <br />OTHER WASTE, THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; <br />AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. , <br />*1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL <br />DISPOSAL IF THIS WASTE IS OVER '1000 P.P.M. TOTAL HALIDES, OR <br />CONTAINS ANY P.C.B'S. <br />too [P] <br />P. P.M. <br />This is to certify that the above named articles are prc )erly classified, closcribed, packaged, marked <br />and labeled, and are in propeyc 'dition for transportal on, according to fhe applicable regulations of <br />the DeparimenLpf Trans,porta q <br />.0 TOMER !le(rU'R-tom DATE <br />(PRINT NAME <br />Z# YI SSF•ID SOE9 E86 60Z YVA ET:ST LOOZ/LZ/LO <br />