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_.,BURY ENVIRONMENTAL SERVICES, D6._ FORM NO.WOES002-D (1/17) <br /> FOR SERVICE CALL: <br /> PARL/ER SERVICE ORDER <br /> 559-498-0240 <br /> FOR ACCOUNTING CALL: N O. N 9083126 <br /> 562-231-1550 WORLD OIL <br /> ENVIRONMENTAL SERVICES,. <br /> 14287 EAST MANNING AVE ❑ PARLIER,CALIFORNIA 93648 ❑ (559)498-0240 <br /> EPA#CAD028277036 <br /> DATE—D L 4 7 1 CUSTOMER NUMBER V <br /> Dod� � <br /> CUSTOMER (' AMOUNT <br /> PHONE q b`{�`�P - `7 7_3 6 6 CONTACT CHECK NUMBER <br /> CUSTOMER EPA# c AD g S 1 Q 6 7 6T0 P.O.NUMBER <br /> JOB SITE ADDRESS'S? 33 AL t, 1" 0�v` {"Y f I^• CASH RECEIVED <br /> /` (� (AMOUNT}COMMODITY Ol <br /> CROSS STREETS HALIDES P.P.M <br /> NOTES: O <br /> ❑ NON-RCRA HAZARDOUS WASTE,LIQUID,(USED OIL./MIXED OILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED' <br /> El NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE-GLYCOL SOLUTIONS)STATE CODE <br /> •NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> ❑ -OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. NO.OF GALLONS (� <br /> DRIVER 1�VcS, (lL��/u 1RUCK NO.s RT. ZQ? I' <br /> ❑ USED'OIL AND GASOLINE FILTERS <br /> ❑ BIG SKY ENTERPRISES; 401 West Channel Rd.,Benicia,CA 94510,CAL 000301639 1-510-541-2128 ������D <br /> ❑ GLOBAL MATERIAL MANAGEMENT, 1640 N.Broadway Ave.,Stockton,CA 95205 CAL 000417316 1-818-770 5 <br /> ❑ SA RECYCLING, 33210 Western Avenue,Union City,CA 94587 1-510-487=9277 MAY 2 2018 <br /> XYUMA YES LLC, 2730 E.13th Street,Yuma,AZ 85365 AZR000515924 1-928-643-8938 <br /> ❑ ALTERNATE FACILITY <br /> _.r : �,; <br /> DESIGNATED TSDF: C1 ASBURY ENVIRONMENTAL SERVICES•2549 Scot Avenue•Chico,CA 95928•CAL000827844 NIT <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-CHICO II,LLC•1618 W.5th St.,Chico,CA 95928•CAD980694103•(800)733-9043 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr.,Fortuna,CA 95540•CAL930256136•(800)733-9043 <br /> ❑ BAKERSFIELD TRANSFER INC. •1620 E.Brundage Cn.•Bakersfield,CA 93307•CAL000282598•(661)377-0308 <br /> ❑ D/K DIXON•7300 Chevron Way•Dixon,CA 95620•CAT080012602•(707)693-6008 <br /> p DEMENNO/KERDOON•2000 N.Alameda Street•Compton,CA 90222•CAT080013352•(310)537-7100 <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave.•Fresno,CA 93722•CAD982446882•(510)795-4400 <br /> ❑ RAMOS ENVIRONMENTAL•1515 S.River Road•W Sacramento,CA 95691 •CAD044003556•(916)371-5747 <br /> ❑ WORLD OIL-SAN JOAQUIN,LLC•14287 E.Manning Ave.•Parlier,CA 93648•CAL000102751 •(559)498-0240 <br /> ❑ ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE This is to ce tit t the above named articles are properly classified,described,packaged.marked <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO/KERDOON THE and lab a In proper condition for transportation,according to the applicable rei,7ulations of <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Dep m sporlation. <br /> 0 <br /> •1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY �/ / r (� <br /> O'rHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 RPM.; X / I P <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S.. CUSTOMER SIGNATURE DATE <br /> •I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X NL' J - <br /> DISPOSAL IF THIS WASTE IS OVER 1000 RPM TOTAL HALIDES, OR <br /> CONTAINS ANY PC B'S. PRINT NAME <br />