Laserfiche WebLink
SERVICE ORDER <br /> - - N"In.............. .................. <br /> o. N 293373 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 2100 NORTH ALAMEDA STREET ❑ COMPTON, CALIFORNIA 90222 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN OFFICE <br /> 1-800-748-5744 EPA NO.CAD028277036 1-800-727-2879 <br /> 1-800-933-9194 <br /> DATE 1�1� • % ONE TIME PICK UP 0 YES or f3"NU <br /> CUSTOMERRESIDENT 0 YES or NO <br /> BILLING ADDRESS ` CONTRACT CUSTOMER ,p ES or 0 NO <br /> -,PHONEi''7`.��}/�:� 5� ` `/ .�J CONTACT ACCOUNT NUMBER <br /> CUSTOMER EPA N ji AMOUNT <br /> JOB SITE ADDRESS ` J <"dt rrf CHECK NUMBER <br /> � ._,r �.. .,, {:.� J •-.�.a P.O. NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> )uaouNt) <br /> NOTES: COMMODITY <br /> HALIDES P.P.M. <br /> I OMBUSTIBLE LIQUID, N.O.S., <br /> (Used Oil/Contaminated Petroleum Products), NA1993, PGIII <br /> ❑RQ, ENVIRONMENTALLY HAZARDOUS SUBSTANCES, LIQUID, <br /> NOS, (Ethylene Glycol &Water), 9, UN3082, PGIII NEXT SERVICE DATE <br /> 0 U.S.DOT DESCRIPTION: DRUMS <br /> MANIFEST NO. r�T! /�l,� NO.OF GALLONS <br /> DRIVER 1 ~�= F -� 4 "t TRUCK NO.&RT <br /> - DESIGNATED TSOF: ❑ -ALVISO INDEPENDENT OIL-6002 Archer St. Alviso, CA 95002 <br /> ❑ BAYSIDE OIL 11, INC. - 210 Encinal St.-Santa Cruz, CA 95060 <br /> ❑ BC STOCKING - 7300 Chevron Way - Dixon, CA 95620 <br /> ❑ DeMENNO/KERDOON-2000 N. Alameda St.-Compton, CA 90222 <br /> __ ❑ OCS-3256 N. Marks St. - Fresno, CA 93722 <br /> RAMOS ENVIRONMENTAL- 1515 S. River Road -W. Sacramento, CA 95691 <br /> This Is to certify that the above named articles are property classified, described, packaged, <br /> marked and labeled,and are In proper condition for transportation,according to the applicable <br /> regulations of the Department of Transportation. <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED X <br /> THIS WASTE WITH ANY OTHER WASTE,AND THE CUSTOMER SIGNATURE DATE <br /> TOTAL HALIDES ARE LESS THAN 1000 P.P.M. <br /> FURTHER AGREE TO ACCEPT THE ADDITIONAL X <br /> CHARGES FOR LEGAL DISPOSAL IFTHISWASTE <br /> IS OVE'i 1000 P.P.M.TOTAL HAGDES - PRINT NAME <br />