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FORM NO . AES003
<br /> IIninIII % _ w _ iSER1/ICE ORIIIIIDER
<br /> gS6t�RY ENV,IRCI`N1�IENT/ SER�/ICES �<
<br /> rtS. 1SANTA FE AUENU �j o �Of;�f�TUN` IIIrIP ,CAIIIfI.1F�12NIf� ' �i0�21 d ' ' (310) 886 34b0 .
<br /> jfIa� fEf'A# CAD028277036�=
<br /> i.. a � . . xx < � � : � ' UN1a9N,aG1�Y. , '„ CI��GO lrFiESNO. , . t .
<br /> DEXO( %
<br /> "" $QO-727=7879 '" � � ` 888=603-8544` -800-733=9043 866'=994=6937
<br /> - = ONET1fVIE PICKUP OYES or (� NO
<br /> III. , z �NIfI � G a
<br /> ; � 3 RESIDENCE ❑ YES or p NO
<br /> CONTRACT�GUSTQMER- _ p`YES.or . ❑ NO =�
<br /> �BILING gt3,DRESS � � : � - � � 'nI+ _" ..
<br /> ibInF Ir I x
<br /> CUSTOMER NUMBER_ �� '
<br />€ HONE Pf� ��- � � � �� $�� �Q�ITACT� - � s
<br /> � AMOUNT
<br /> _t
<br /> CUS�OMEREP�t� � � : . . . .
<br /> #* j CHECK NUMBER
<br /> E ADDR
<br /> J®B ' SITESS � r '3 ` � � �
<br /> , ' � � � PO � NUMBER s
<br /> ' � CASH R�cEIVEo% '= -. . :
<br /> r
<br /> _CRASS STREETS "
<br /> � IIIr . O
<br /> -tAMUNTj
<br /> � �COINMObITY _
<br /> IInT IN
<br /> HALIDES '� . `Pt� M
<br /> p �NON�t�GRA�`H �4��`�ASTE, L�UIb (USED IL%IVII�ECT"O1L�} >STA'TE COD>= ."`Z2� ` ` IN
<br /> *NO PIACARpS= REQUIRED* '
<br /> a C3 -NON RGRA HAZARi10US W� TE, QUID (ETH YLE NE GLYCOL SOLtJT10NS) STATE GOOE ; NEXT SERVICE"DATE
<br /> _ � O l'LAOAR6�OFi MARKIN'�S�R� U�RED* - ;;
<br /> I
<br /> : . , . . � DRUMS
<br /> _ _ DRUM SIZE _
<br /> p . �OTHER
<br /> � -� NO OFGALLONS1 � > �
<br /> IIIffIII
<br /> III
<br /> �� -MA►�IF�ST"NO � > g � �� " _
<br /> TFiUCl� NO & RT.ra
<br /> bR_1ClER '
<br /> x ,
<br /> II( ' USED OIL AND GASOLINE FILTERS
<br /> ' ❑ , SAAECIFCL'IInIaIfNG 332id�fVester+i�Avenii� �n'ion City i3O.�45 -1510 487=9277 ` -
<br /> ❑ ALTERKl7XTET�A`CiL�TY ���
<br /> p PSBURXNIifII % ROIIUE ALSEFVICES * 2549 Scol Rve%nue * ,Chico; CL# 95928 +." CAL59 8?•C [2980694103 .(80Q) 3r9Q.43 r
<br /> DESIGNATEDTSDF. [n-11C W I
<br /> [� ASBURY- fvN1lIR0 1 ENT/W I __�1�:) CrF# Q ,1� ISI C 1�t4$ W Sth.St rCJuna, CA 9, 2 A : �' , . _
<br /> p ASBURY EIRVIROf 111 II I SERVICE FQRTUNA • ' 20 Dlnsnoor'e I r., Fortuna, CA 955d0�� AL93025613fi • (800}' 733-9043
<br /> ' ❑ BAKERSEIELD ANSFER INC. • 1% 620 E: Brundage Ln. • Bakersfield; CA 93307 • CAL000282598 • (661 } 377-0308
<br /> � ❑ D!K DIXON • 73 0 Chevron Way is DIN CA 95620 • ;CAT080012602 •'(707) 693-6008
<br /> ❑. L2EMENNO/KERDOON • AL , N. Alameda Street • Compton, CA 90222 ! "CATO$OOi8352 • 2825 8 4i (6 00
<br /> p'= EVEF)GREEN ENV. • 4139 N, Valentine Ave. • Fresno, CA 93722 • CAD982446882 • (510) 795-4400
<br /> iAMOS,E�N�UIRONMENTAL • 1515 .S. River Road • W. .Sacramento, GA95691 • CAD044003556 • (916) 371 -5747
<br /> ❑ Vl/013LD 7t, SAN JOAQUIN, LLC,:• 14207`RE..-Manning Ave. '•°Parker, CA"93648 • CAL000102751 • (559) 498 0240
<br /> p ALTERNATE° C L1T)C % � � . . .
<br /> : , ariR SEDIINTIFREEZE AND OILY WATER WASTE STREAMS,' ARE This is to�certity. that =the above riameii. arUcles are properly, c�assified, od�lsera described,
<br /> regulatior § of
<br /> USED
<br /> :RECYCLEDAT-0nIIt3R SISTER `.COMPANY DEMENNO/KERDOON�THE antl labelei , an�lare_m. proper conddwn�for transportatibn, according PP
<br /> LARGEST RECYCLER=OF USED OIL IN THE WESTERN :UNITED STATES , the Departrtlent o[Trarisportati4rk =
<br /> ( - . _ .. e_.._...._.� 113 �
<br /> ' *LHEREBY=G)rRT�FI" �11A1� I B��/E ;NOI�MIXED�THIS W/ T�NtITH" . ANX - - � � �� . : '� �
<br /> OTHER �VAS7E, THAT, �'kIE �TC� �. f�LID /�RS� LESS THAN ; 000 �? � �!(1 s X ,�; n `� � r 5 ' '% ' t °` � - �'' DATA_ . . .
<br /> ` ANDTHAI± THE WAS`LE.DOES` NC27�BlN`ANY.PCs S.._ ; _ _._-,-� ��.�.+�` �Us'IQMER.SIGNATUAE` _ __ . „ . ,
<br /> " . '!`FURTHER AGREETO ACCEPT THE ADDITIONAL if
<br /> CHARGES FOR LEGAL
<br /> DISPOSAL IF THIS WASTE IS ' OVER 1000 P,P. M . TOTAL HALIDES, OR Y
<br /> " PRINT NAME
<br /> , CONTAINS ANY RC:B'S,
<br /> -
<br />
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