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_ _- -- SERVICE ORDER <br /> No. N 272709 <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 �? ONE TIME PICK UP 0 YES or O-NO <br /> /7 <br /> CUSTOMER (' r r �'"_-7 RESIDENT 11 YES or ❑'NO <br /> BILLING ADDRESS CONTRACT CUSTOMER El YES or 0 NO <br /> PHONES CONTACT ACCOUNT NUMBER <br /> CUSTOMER EPA M '+ AMOUNT - <br /> JOB SITE ADDRESS '% - CHECK NUMBER <br /> P.O. NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY _ <br /> HALIDES P.P.M. <br /> PxCOMBUSTIBLE LIQUID, N.O.S. (USED OILS&MIXED OILS) <br /> NA 1993, PG III <br /> 0 ETHYLENE GLYCOL NON-RCRA <br /> HAZARDOUS WASTE LIQUID NO PLACARD REQUIRED NEXT SERVICE DATE <br /> 0 U.S. DOT DESCRIPTION: DRUMS <br /> MANIFEST NO. `-� NO.OF GALLONS <br /> DRIVER TRUCK NO. &RT ' <br /> DESIGNATED TSDF: ❑ ALVIS ; INDEPENDENT OIL-5002 Archer St. -Alviso, CA 95002 <br /> ❑ BAYSIDE OIL II, INC. - 210 Encinal St. - Santa Cruz, CA 95060 <br /> ❑ BC STOCKING - 7300 Chevron Way- Dixon, CA 95620 <br /> ❑ DeMENNO/KEROOON - 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 V <br /> THIS WASTE WITH ANY OTHER WASTE,AND THE A <br /> TOTAL HALIDES ARE LESS THAN 1Q00 P.P.M. CUSTOMER SIGNATURE DATE <br /> I FURTHER AGREE TO ACCEPT THE"ADDITIONAL t X ' �!�1V1';- I-' <br /> CHARGES FOR LEGAL DISPOSAL IF THIS WASTE + "aJ�nl {^" <br /> IS OVER 1000 P.P.M.TOTAL HALIDES PRINT NAME <br />