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WORLDWORLD OIL --- - <br /> RCOM <br /> 0 <br /> TRANSPORTER EPA WWWWORLDOICAD4 <br /> I I I x I I .5 USTOMER/ CHASE ORDERI RC UTEI TRUCK/ CONTACT NAME ORDER TAKEN BY NAl#DE$ <br /> R x Lur.r rrnrr I or.I.R Lrn. r< DaTE REOdPED LAdMCJ MANIFEBT/ <br /> OESCRIPi10N - - I7REC <br /> :DESC7RIPTION QTY UNIT PRICE OTY PN TOTAL <br /> TOTAL <br /> U N-ACRA H—RDOUS WASTE.LIQUID(U EE HYMI EDOOIL,INFORMATION <br /> NON RCRA NA RDDUS WASTE LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE 221 <br /> OTHER: STATE CODE_ <br /> I DESIGNATED TSDFLTE : - - -- - - — —_ <br /> ARNATETSDF -- —_ --- <br /> DRUO <br /> MS PN:_ EMPTYDgUMS <br /> FACILITY: BSC__ <br /> GENERATOR WgSTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX) <br /> •I f Waste olI geneietor/customer MUST check ONE of the following three boxes) <br /> -R­ <br /> = <br /> ovP" "ai.a„„�^.a#lcw.i.•« <br /> ':��Ed„,."s':�"n""«a <br /> '�Iw,«e'•: „'y'p,^„„•'a�`�:��a°��«„...�.°��,«..«w�.N ws ,...�"Lo.«"„' °.......".,... p,:.�k`..o�m:.a�rm�'�° <br /> Wm,,,,,,,••P,�„1" „ w(All genemtors/customers MUST a^•�a:e°�ea�r�ni"„:;°;,„„,°;�' •^°^�^«•«•,,,,,.««„«,«„„, <br /> read the follDwl'n text <br /> 001114" <br /> WORLD OIL <br /> URCHASEORDER# ROUTE' T CT NAME ORDER TAKEN BY NALJGE6 PURC#LgbEDRDEP/ ROU1E/ CIAA I <br /> OgDlR TAKFN By IyL,�B <br /> F LAdxw E•ANNFbT <br /> PART# DESCRIPTON rAMITI DESCRIPTON LL PI <br /> DTV UNIT PRILE I TY PN TOTAL oTY UNIT PRICE OTY PN TOTAL <br /> I <br /> CASH REC'D:___ CHECK/_--_- TOTAL AEH-C-- TOTAL <br /> WASTE DISPOSAL INFORMATION N RCRq Ng2ARDDuS WASTE,UOURr(USED OIELxTE D DE OILS) <br /> INFORMATION <br /> 0 <br /> . D <br /> E NOMRCRA NAZAgDOUSWASTE,LIQUID(JSED OIUMI%EDDIES) NONRCRq HAIgRDpUS WgSTE lIOUIp IETHYLENEGLYCOLSOIUTION51 <br /> < THER, AHAZ coUSWAETELC1D(I THYLENE GLYCOL SOLUTIONS) - STATE CODE 221 OTHER STgTE CODE 221 <br /> OTHER __ - DESIGNATED TSDF. STATE CODE <br /> DESIGNATED TSDF — - ------ - STATE CODE_ ALTERNATE TSDF: <br /> ALTERNATE TSDF' - -- _ - - -- <br /> I -- ---- —_ <br /> DRUMS PN' -_ -- - DRUMS ALL EMPTY DRUMS: <br /> EMPTY DRUMSFACILITY: <br /> FACILITY BSC <br /> BSC GENERATOR WASTE CEgTIFICgTION <br /> GENEgATOA W „"�`np°u""xiDi '« (PLEASE CHECK THE APPROPRIATE BOX) <br /> rPPn.s°Mpxr^•^w«mnwr; IFICATION(PLEASE CHECK THE APPROPRIATEN(Wes-e o'geR�TatOy"W"ImBr <br /> (Waste oll gen BOX) MUST cheek ONE Of the followln th <br /> MUST check ONE of the followln „#^,,,`,°„^•p «.,,,x„rµ ras box <br /> • rte”' 9three boxer) M1b'"^^« _ <br /> Ewr«y «u.°a«.w«rxm�nm„a ywlil°' `'„•�.��rw�r _ .«m w«�n.,«aar ww.Mlllr N:YI <br /> bMbgIEY <br /> Print Driver NRmn <br />