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;_1-1 0'-L r 11R'IR I�_J]L.L-C!1AL_4_. L -L— FOR FOR SERVICE CALL SERVICE ORDER PARLIER ASBURY ENVIRONMENTAL SERVICES, I]BA FORMNO.WOES()04-D WIT) 559-498-0240 SERVICE ORDER NO• FOR ACCOUNTING CALL: VIfU 5M 562-231-1550 "OrA Y C) AF 20o WORLD OIL s ENVIRONMENTAL SERVICES- H 1.1.1 I til-,A Ci+_Itcx�]•'��-n A :;MC: 14287 EAST MANNING AVE,PARLIER CA 93648 11-559-498-0240'3;"l AIJI 0 CENTER CIRCLE 3:'81 AUTO CE•t ITUR C:IR,,A-E E WWW.W0RLDOILCORPCOM STOO<Tt�t�. CA P1121t T TRANSPORTER EPA#CAQ428277036 STOCK7C41, CA 95212 i ff1p 1951-i 14O 12081`ry 1 2140 CUSTOMER# PURCHASE ORDER# ROUTE# I TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES i• I .I a•.?-i. -Ilii•! PATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA N BILL of LADING/MANIFEST N j IJ r 'ifi.'{ Z -9 -))l PART# DESCRIPTION QTY UNIT PRICE QTY PIU TOTAL 5, cl�E7CONDIIJONF-D) $5200 7 !I.y � i I`�rl.Y iCr�l rC)S r-F-R FiRUTA S111,35 00 F 101 i 'r]! 9lfr1-5116 BATCH s r:fr, ,xa TOTAL CASH RECD: CHECK# WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATEDTSOF: ALTERNATE TSDF: DRUMS PIU- EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION (PLEASE CHECK THE APPROPRIATE BOX) By signing below I hereby certify that. (Waste oil generator/customer MUST check ONE of the following three boxes) pa 1)t have not mimed any of the waste described above with any other hazardous waste,the total halide canteot is LESS than 1,000 ppm,and the waste does not contain any PCBs.t have complied-ah the requirements of the applicable California used ori management regulations to determine this is true.I agreetoaccept the additional charges for the disposal of thiswaste If the m(ofmaocin I have provided about[his waste Is imoirect QIZ I have not mixed any of the waste described above with any other hazardous waste.the total halide content is GREATER than 1,000 ppm,and the wastrdoes not contain any PC$s I have provided proper documentation to World Oil Environmental Services to rebut the presumption that this waste was mired with other hazardous waste-I agree to accept the addruunaJ charges Ior the disposal of this waste if the inforrrsation I Now provided about this waste is incorrect E 1#31 rhes waste is from a tank which collects waste oil from household'do-it-yourself'ODtY)andlor Conditionally exempt small quantity generator(CESOG)soueces.To the best of my knowledge,the only waste oil coniained m my DfY'CESQG colli ion tank is soley from DIY and/or CES06 sources.I have not mixrd this waste oat with any other hazardous waste of waste oil from other sources.I ageee to accept the additional charges for disposal of this waste if the inforrnation I have provided about this waste is incorrect (Ali generators/customers MUST read the following text and check the associated box.) 1 If I am a large gwm yty generator,I cM1fy that 1 have a program in place to reduce the voturne and toxicity of waste generated to the degree I have determined to be economically practicable and that I have ted the practicabie method of treatment storage.or disposal currently available to me which minimizes the present and future threat to human life and theerivironment:0r.if I am a small quantity generator.I leve made a good faith~to minifntle rrrywaue generation and select the best waste management method that is available To me that I can afford rhes mdnaduaf wpmg in the space set loch below on behalf of Customer represents and warrants that helshe has the authority to bind Customer,[hat the forgoing descriptions of waste aid malenats are true and accurate as packaged marked and labeled,are ready for transportation in accordance with applicable state and federal regulahans,and that Customer shall abide and be bound by the Starsdard Terms and Condnroopa7n the reverse s+de of OWS Service Qrda+ Customer Signature Date driver ign ure D e r Print Drivers Nam Print Name Scanned with CamScanner