Laserfiche WebLink
FnF11.1. NO AcVX <br /> - - -- - SERVICE ORDER <br /> - -- = NO. fel lkCf ( 4 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1309 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 902�e ;3101 886-3400 <br /> EPA#CAD028277036 <br /> DIXON UNION CITY CHICO FRESNO <br /> 800.727.2879 888-603.8844 800.733.900.3 866-9946937 <br /> DATE - ONE TIME PICK UP OYES or ❑NO <br /> CUSTOMER RESIDENCE ❑ YES or ❑ NO <br /> BILLINGADDRESS CONTRACT CUSTOMER ❑ YESor ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# - AMOUNT <br /> JOB SITE ADDRESS ._.." CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> IAMOUIM <br /> NOTES: COMMODITY '- <br /> HALIDES P P 1.1. <br /> '7 NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILJMIXED OILS)STAFF CODE 221 <br /> *NO PLACARDS REQUIRED* <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SCLUTiONS)STATE CODE <br /> NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> OTHER DRUMS DRUM SIZE <br /> MANIFEST NO, NO.OF GALLONS <br /> DRIVER TRUCK NO.&RT. <br /> ❑ USED OIL AND GASOLINE FILTERS <br /> ':1 SA RECYCLING, 33210 Western Avenue,Umon City,CA 94587 1-510-467-9277 <br /> - ALTERNATE FACILITY <br /> DESIGNATED TSDF -1 ASBURY ENVIRONMENTAL SERVICES•2549 Soot Avenue•Chico,CA 95928•CAL000827844 <br /> ASBURY ENVIRONMENTAL SERVICES-CHICO II,LLC•1818 W.511h St_Chico,CA 95828•CAD980694103•(SW)733-8043 <br /> ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr..Fortuna CA 9$540•CAL930256136•(600)733-9043 <br /> ❑ BAKERSFIELD TRANSFER INC. • 1620 E.Brundage Ln •Bakersfield.CA 93307•CAL000282508•18614 377.4309 <br /> ❑ D/K DIXON•7300 Chevron Way•Dixon,CA 95620•CAT080012602•(707)693.6008 <br /> ❑ DEMENNO/KERDOON•2000 N.Alameda Street•Compton.CA 90222•CAT080013352•(310)637-7100 <br /> ❑ EVERGREEN ENV.•4139 N,Valentine Ave.•Fresno,CA 93722 •CAD982446862•(510)795-4400 <br /> ❑ RAMOS ENVIRONMENTAL• 1515 S.River Road•W.Sacramento,CA 95591 •CADD44003556•(916)371-5747 <br /> ❑ WORLD OIL-SAN JOAQUIN,LLC• 14287 E Manning Ave.•Parker.C?G'i •C-.1.[,50102751 •(559)498-0240 <br /> ❑ ALTERNATE FACILITY _.. <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This1110 <br /> 5 N CMLry Lhe1 ale above r'amed arlkles are property Classified,described,packaged, marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO'KERDOON THE and 411101 Brd are In proper mndllwn for transportation, aCC-0rding to the applicable regulalWn3 0l <br /> LARGEST RECYGLER OF USED OIL IN THE WESTERN UNITED STATES. the Department of Transportation. <br /> `I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THATTHETOTAL HALIDES ARE LESS THAN IWO P.P.M.; X I_J <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER S10N+Net FAI <br /> `I FURTHER AGREE TO ACCEPT THE ADDITIGNAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS OVER 1oD0 P.P.M.TOTAL HALIDES. OR <br /> CONTAINS ANY P.C.B'S. PRINT NAME <br />