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S FE R V I C[E. 0 F 3 D ER FORM NO.AES001
<br /> SAN DIEGO OFFICE
<br /> 1-800-748-5744 SERVICE ORDER NO;
<br /> iVORTHERN OFFICE
<br /> -6 967 1?
<br /> 1-800-7-ASEURY
<br /> ASBURY ENVIRONMENTAL SERVICES
<br /> S 1300 S.SANTA FE AVENUE e COMPTON,CALIFORNIA 90221
<br /> H 1311.0)886-3400 - FAX(310) 763-5922
<br /> �DEP*T. -PARKS NNIM.'TkE TVII Cc
<br /> P EPA#CAD028277036
<br /> P 4f,"M CAT."'POL '314'04 (1-10,105 145)110iKIIT
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<br /> t17 51 T V A 11i,
<br /> T U., ?r5-1-57.0" CA 1'4!VW,[
<br /> 0 f?2tj1) it <925) 4355-05?9iLl
<br /> CUSTOMER PUR HASE ORDER SALESMAN. CONTACT,
<br /> 4
<br /> ..DATE REQUIRED, SlfIIPPEDVIA DATE*ENTERED CUSTOMER EPA ID`NUMBER� HALIDES PP.M.',,
<br /> f"AU 'Ut-")24 6 1,t�,
<br /> i-3 T. V y e� 4��. I '.I
<br /> 5 ✓30 i,-� 5 fl).;
<br /> PLEASE PAY FROM THIS SERVICE ORDER
<br /> QUANTITY-,'
<br /> RDERED -
<br /> SHIPPED 8/0
<br /> PRODUCT NO. DESCRIPTION OCUSTOMER COMMENTS:.;-
<br /> 11�7
<br /> 71 t3l
<br /> T-
<br /> -4,
<br /> F
<br /> WASTE DISPOSAL INFORMATION, 4. PAYMENT INFORMATION'
<br /> NON-RCRA-H.AZ,ARDOUS WASTE,LIQUID(LISED OIL/MIXED OILS) STATE CODE 221
<br /> *Nb PLACARDS REQUIRED',.
<br /> GALLONS:. AMOUNT(if any),
<br /> NON-RCRA HAZARDOUS WASTE,LIQUIDS CODE
<br /> ETHYLENE GLYCOL SOLUTIONS:*NO PLACRDS REQUIRED*-
<br /> D.RUMS. ::'CHECK NUMBER
<br /> NON-HAZ.DRAtNED USED OIL FILTERS FACILITYt
<br /> 2- DRUM SIZE:.
<br /> :P.O.NUMBER'
<br /> 'OTHER:
<br /> MANIFEST NO. CASH-RECEIVED
<br /> TRUCK NO.
<br /> El-biSIGNATED TSDF: DeMenno/Kercloon,2000 N.Alameda Street, Compton, CA.90222, (310) 537-7100,CAT080013352
<br /> El DESIGNATED' TSDF:Advanced Environmental, Inc.,
<br /> nc., 13579 Whittram Ave., Fontana, CA 92335, (909)356-9025,.CAT08002571 I
<br /> E]ALTERNATE TSDF:
<br /> NOTES TO DRIVER
<br /> NEXT SERVICE DATE
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<br /> All F"
<br /> ATE'L , I� r <r - K Y(' r
<br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTEf7 1,'X.RUhti 11411"1". TIF, t-11-A-J-J11UA7,A-TET! AS F01J.10U.,S) ."FR fitAL.
<br /> WITH ANY OTHER WASTE,THAT.THE TOTAL HALIDES ARE
<br /> LESS THAN 1000 P.P.M.; AND THAT THE WASTE DOES NOT['4,- VVK70--, Alf" Q
<br /> CONTAIN ANY P.C3'S. P U e? N
<br /> .A"
<br /> I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES—
<br /> FOR LEGAL DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.v�`WYY CtAf F /04 41;nu- 'C.L
<br /> TOTAL HALIDES,ORCONTAIN-S ANY P.C.B:S.
<br /> This is to certify that.the above named articles are properly classified,described, packaged,
<br /> marked and labeled,and are in proper condition for transportation,according to the applicable
<br /> DELIVERED BY DAIE f
<br /> regulations of the Department of Transportation,
<br /> PRINTNAME ell
<br /> DAT
<br /> RECEIVED By 7 DATE SIGNATURE: E
<br />
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