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05/14/2007 12: 10 FAX 2094666114 RLDIESEL IM 003/003 <br /> 707-77, <br /> FORM NO.AEM <br /> SERVICE ORDER <br /> Room 0. r_— <br /> J1111111111 <br /> N . N 573024 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE c3 COMPTON,CALIFORNIA 90221 o (310)886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPA CAU028277036 1.800-727-2879 <br /> DATE -7 ONE TIME PICK UP MMES or�No <br /> CUSTOMER RESIDENCE 0 YES or)2f NO <br /> BILLING ADDRESS CONTRACT CUSTOMER YES or 0 NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER A I D 1.0® <br /> CUSTOMER EPA# 194j 3 f, I A AMOUNT <br /> J013SITE ADDRESS CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY--N/,E <br /> HALIDES P.P.M. <br /> 0 NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED 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* NF-)(T SERVICE DATE <br /> [I OTHER DRUMS DRUM SIZE <br /> MANIFEST NO, .7,' .7 NO.OF GALLONS <br /> 7— <br /> DRIVER (RUCK NO.&nT. 7 <br /> 0 NONHAZARDOUS DRAINED USED OIL <br /> [I COMMERCIAL FILTER RECYCLING,33210 Western Avenue,Union City,CA,510.487-9277 <br /> 0 ALTERNATE FACILITY <br /> DESIGNATED TSDR El ALVISO INDEPENDENT OIL-5002 Archer Street,AlvIso,CA 95602-CAL000161743•(510)476-1740 <br /> [I SAYSIDE OIL 11,INC.-21 a Encinal Street-Santa Cruz,CA 95060-CAD088838222-(40a)427-3778 <br /> M EVERGREEN ENV.®4139 N.Valentine Ave.e Fresno,CA 93722*(510)795-4400 <br /> r7I DEMENNOIKERDOON -2000 N,Alameaa Street-Compton,CA 90222-CAT08001 3352 0(310)537-7100 <br /> 13 WK DIXON®7300 Ctwmn Way e Dkon.CA V51011*CAT0e001 2002 a(707)693-6008 <br /> /— RAMOS ENVIRONMENTAL o 1515 S.Rhw Road .W.Sacramento,CA MI.CAD044003666 371-5747 <br /> • ASBURY ENVIRONMENTAL SERVICES*2549 Scott Avenue s Chico,CA 9692e,CAL=827844 <br /> • ALTERNATE FACILITY <br /> USED Oil,USED ANTIFREE AND OfLY WATER WASTE STREAMS ARE <br /> RECYCLED AT OUR SISTEZER COMPANY DEMENNO/XERDOON THE This is to certify that The above named articles are properly classified,describedpackaged, marked <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES, and labeled,and are in proper condition for transportation,according to the applicable regulations of <br /> the Dagarlmerit of Transparlation. <br /> 11 HERESY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> 1 C <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; 4 7 <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY PC.B'S.. CUSTOMER SONA'WRE DATE <br /> 41 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> CONTAINS ANY A.C.&S. PRINT NAME <br />