COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

FOR SERVICE CALL: SERVICE ORDER -'FORM NO.WOES004-B(0/18) DIXON OFFICE ASBURY ENVIRONMENTAL SERVICES, DBA 1-800-727-2879 SERVICE ORDERNO. FOR ACCOUNTING CALL: ®WQRIeD„O'L 562-231-1'550. ENVIRONMENTAL SERVICES,. S 7300 CHEVRON WAY,DIXON,CA 95620 H a TEC OF CALIFORNIA- LOUISE AVE 1-800-727-2879 P 2050 E LOU-ISE AVE WWW.WORLDOILCORP.COM 2050 E LOUISE AVE D _ TRANSPORTER EPA#CAD028277036 - o LATHROP,CA 95330 LATHROP, CA 95330 (209) 858 4110 (209)858.4110 CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES. TEC805 CER-88 (ji 'A BARRY Sc DATE REQUIRED DATE ENTERED NEXTSERVICEDATE CUSTOMER EPA# BILL of LADING/MANIFEST# grew019 9/17/2019 CAL000415460 PART# DESCRIPTION OTY JUNIT.PRICE QTY P/U TOTAL OF USED METAL OIL AND GASOLINE FILTERS 2 $55.00 a $110.00 OFDR OIL FILTER DRUM REPLACEMENT- NO CHARGE 2 $O:OO $0.00 BATCH • TOTAL CASH REC'D: CHECK WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID USED OIL/MIXED OILS) STATE CODE 221 NOWRCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE � •�� OTHER: — DESIGN i4 y4,Yu AZ 85365,818 114 GBZfl ALTERNATE TSDF: . _CrO o atret+fr' M,y s DRUMS P/U:___g_ EMPTY DRUMS: FACILITY:- BSC ' GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX) By signing Wow l hereby.ceNfy that: (Waste oil generator/customer MUST check ONE of the following three boxes) 0 91)1 hove net sailed-Yof a wp to eacrmed above with eny other narnrtldae ilea e,dee toted mild.contend Is LESS than 1,ogo ppm,erld the w4ato 9aoe net mptat any PCfla.l hltup < aanpilatlaylN pea reaWremonl0of Iho applleabla Calllomp used oil mamgement mgulagona m daMmine Mists We.I agree to aceept'the sddldullzioliargea ftN tlld dlry4osel al tills patdaN the Inform rtioni have Provided about this waste Is Incorrect - o e21 have not mined any of 6 waste d wribed above with eny other haterdoua welts,tha total hallo content Is GREATE11 then 1.m PPm.land tm mraW does that eeMeln any PCB&1 have Provided proper deeumentsoon to world oil Fmhonmental services to react the presumption that this waste was mixed wide other mzaidousislAt lagrm'to".0 tlhuz lbd9l chargaa for Ne disputed of this we me it No Intends" n 1 have provided abmd true we are Ie th 0mee, - [] r3)Trus waste p}relga poli which wleels waste oil from household"do-it-youneif(UI Y)a of anMltlonel niempl tm�yudnVty' hdieloi l SGG)spy-Sda jo the besi of my wnowlodgo,thisoily wd}tdal'eordemEd In my nmCESGG collection hok In coley from on an&"E56G 1havermt i£�d ddrt�vrtge wl wrih�en Omar mtadow Merte of wtamen from odwr saud"s;I BUT"to accept this.ddllaaw cherde,$ai msposalot oda waste if the ul.headon lhavepfpvldBdlebold m)s'w4stegllrc'o'tye'cr (Ail generators(customers'MUST read the foilowingftext , Lrmraty that i have a program in plegia to reduao the volume and toxicity of wasto geaemted to the degree I have asterminsd to W mandmldally pmaticablo erld marl have soeled the ' Precdcebl-Mathed of tmalm.t etorege,or deposal ovrrendy dvellebe to oro Wait mlnlmlaea the Present end futum threat to human aft and pee environment. This aMlvidlnl signing in the spear set forth Wow on behah of customer naudsome andwtutanis thal h lahe hag the dudiodiyto'bindcltatoinyr,Net the forgotrg tlexdpdov of weals) avid materials aro true sled atturap u packaged,marked,end labeled,are needy for tmmportetbn In aecordsnce with eppllcetJe'efete and t='l rsgulatbna,and Net customer ahtll aWdo M the SprMerd Terms end Condltlons on the nwvase side of this S hm order. - S Isa Crdera with an assoclaW haaanfous waste manifest(either site opeolk or consolidated)am subleut loan EPA Fra. These feeefavor the EPA"...through foe and adminbtiahon of me emanleat progmm. Thdae fads very,rased on NanHost type Applicable feet will appear an your bluing Invoice. l omer�reDate ' •:x., Driver Signature Date Yl.I �Ip, Print Name Print fyriwur Ned mo