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T <br /> , . FORM NO.AES003 <br /> SERVICE ORDER <br /> No. N 598312 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 90221 ❑ (310)886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPA CA0028277036 1-800-727-2879 <br /> DATE ONETIME PICK UP DYES or ❑NO <br /> CUSTOMER RESIDENCE ❑ YES or ❑ NO f <br /> BILLINGADDRESS CONTRACT CUSTOMER El YES or ❑ NO .i <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER i <br /> CUSTOMER EPA 8 AMOUNT <br /> JOB SITE ADDRESS CHECK NUMBER <br /> I <br /> P.O.NUMBER I <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES P.P.M. <br /> I <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. NO.OF GALLONS <br /> I <br /> DRIVER TRUCK NO.&RT <br /> I <br /> ❑ NONHAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City,CA,510-487-9277 <br /> ! <br /> ❑ ALTERNATE FACWTY <br /> DESIGNATED TSDF: ❑ ALVISO INDEPENDENT OIL-5002 Archer Street•Nviso,CA 95502•CAL000161743.(510)476-1740 <br /> ❑ BAYSI DE OIL II,INC.•210 Encinal Street•Santa Cruz,CA 95080•CAD088838222•(408)427-3778 <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 /> EI D/K DIXON.7300 Chevron Way.Dixon,CA 95620.CAT080012602•(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S-River Road .W.Sacramento,CA 95691.CAD0440035M .(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico,CA 95928-CAL000827844 <br /> ❑ ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This Is to certify that the above named articles are properly classified,described,packaged,marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and labeled,and are In proper condition for transportation,according to the applicable regulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <br /> 4 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY li <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.: X <br /> AND THATTHE WASTE DOES NOT CONTAIN ANY P.COS.. CUSTOMER SIGNATURE DATE <br /> 4 FURTHER AGREE TO 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 /> i <br />