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e 'SERVICE ORDER;,,:. <br /> No. N <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 JPA NO.CAD028277036 1-800-727-2879 <br /> t 1-800-933-9194 <br /> DATE (? V17 ONE TIME PICK UP 0 YES or f]'RO <br /> CUSTOMER 171 RESIDENT 0 YES or 0,NO' <br /> BILLING ADDRESS CONTRACT CUSTOMER 0 YES or 0 NO <br /> PHONE: tif / !rt- a_ CONTACT ACCOUNT NUMBER <br /> CUSTOMER EPA M r'�:-. - •..'�; AMOUNT <br /> JOB SITE ADDRESS I ' `-` %`t'- = ' CHECK NUMBER <br /> L.- P.O. NUMBER <br /> CROSS STREETS +• CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: - COMMODITY <br /> HALIDES P.P.M. <br /> 17`60MBUSTIBLE 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 SERVICFPATE <br /> ❑'U.S. DOT DESCRIPTION: DRUMS - <br /> MANIFEST NO. �- r - /- NO.OF GALLONS J ! -- <br /> DRIVER TRUCK NO.&RT -� - <br /> DESIGNATED TSDF: ❑ ALVISO 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/KERDOON- 2000 N. Alameda St. - Compton, CA 9-0222 <br /> ❑ OCS- 3256 N. Marks St. -Fresno, CA 93722 <br /> -- IY- RAMOS ENVIRONMENTAL- 1515 S. River Road -W. Sacramento, CA 95691 <br /> This is to certify that the above named articles are property classed, 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 <br /> TOTAL HALIDES ARE LESS THAN 1000 P.P.M. - CUSTOMER SIGNATURE DATE <br /> I FURTHER AGREE TO ACCEPT THE ADDITIONAL <br /> X <br /> CHARGES FOR LEGAL DISPOSAL IF THIS WASTE PRI1fAlAL1E <br /> IS OVER 1000 P.P.M.TOTAL HALIDES <br />