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....�-. ��.�---�. •^—�'T7',yT .•'M; - -'y....-.�"^^ -+�.„''ar�G_�•`•,rg,.-..�,.:.,Ar-; .-';. ,.i-.•-r;--^-„�TraA:�:.-.-�•-:�,v.�. FO 5 ► 1c1=CALL: �AigLr :SERVICE QRQER ' �9 ASBURY ENVIRONMENTAL.SERVICES, DBA' FORM NO,WOES004=D (1/17) ' .: u 559-4S8-Q2��pSLr' SERVICE ORDER NO, FOR ACCOUNTING CALL, woply N25420.26 562-239-1550 ' Al .1QC7:. WORLD.OIC ENVIRONMENTAL SERVICESrrr r, 1'4287 EAST MANNING AVE,PARLIER CA 98648 QUEST wiT F� }f.� + .f}♦7Ofl�T•'FIRE' f' fl ;aft�hfk , ,3� 3 P ►W1""Al�11�1�. 7 sss ags-0a4o X317 MAN t;"f�f��r� ti IJYI'f�Q;1.t3 P WVVW.WORLDOiLOORP(GOM �:f�IS=7X NOV � TRA.CY,!CA 953*7i • TRANSPORTER EPA#CAD028277036 , C.U'•_TOMER# PURCHASE.ORDER# ROUT.E# . ' TRUCK.4 CONTACT NAME ORD.ERTAKEN BY , HALIDES'. DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of I ADINGIMANIFEST# CAL000377396 PART# ' "DESCRIPTION QTY UNIT PRICE• QTY P/U TO'i'AL -C:c s[r. 5/st 7 i•..q WAS •T OVA ED MAS"!"I NE OPEN M4-7,7PM 5A1 7•61*1 st.'N'0-61"M ofitT"to_—_ - ••: " fit'• lec ., 'LY7 ... :,.r•''• ` .TATA - - td to to ~tpvra Y r¢3 C• - _ L CHECK# WASTE DISPOSAL INFORMATION I+1QN RCRA'HAZAR.DOUS WASTE,,LIQUID tLkSED CYIL/MfICED AILS} f.• STATE CODE 221 NONRCRA HA7ARf�bUS 'OTHER. WASTE,LIQUID{ETHYLENE GLYCOL SOW]IONSr STATE COD1 ., s DESIGNATED---SDR ALTERNATETSDF: DRUMS PIU: EMPTY DRUM5: FACILITY' B5C ~ GENERATOR WASTE CERTIFICATIOW1(P,LEASE CHECK THE APPROPRIATE BOX) r. . By signing below I hereby grtlry thar. (Waste oil.generatoNcustarner MUST check ONE of the fallowing thred boxes) •,dYiJ l have ntit.mlxed any=pf ihn waste desSrlped aba+re with arUr other iraaardaus waste,the total Inalide eanteni is LESS tharj•),OW ppm,and the waste does notcanwin any past Ove campled with the requlremen[saF the applicable California used on marragetaent regulations to determine this Is true.I agree to a[cept the addiUanal charges for thedf3posal of thlswasre If the inforinaUen 1.1 snve ptovldedaliout d+ls wasteislncorrect tZjW2'I have not mixed any of the wastedescfibed above with any other,hazardous Warne,the total halide wntont Is GREA ban 1 0 ppm%and the waste does not cantalnany PCBs t • k. have provided piopmdocumentao6rr to World Oil Ertvironmerital Survices10 rebut the.prrxu"`IAP that tt}[swaste was mixed with dther,hazarclouswaste.l agree io.accept the addittonoltharges far the disposal of thl waste If the information I have-pravwed.abaut thtswaste Omormct cY . !l3l This waste is from a tarikwhich�oBects waste bll•1{omhousehold"do•k yourselr"�plYl arnllorcondldonalii exeirq tsrrw(lquanpty generator It FSQGJ.sources.To t{+elsestaF my knowledge the idntained 'in my OEYICESOG[oltoclionitink is sdey from AlY and/or{FSOG wurces.l have not rniSsd thiswasie clt-wlda,aFW giber hanrdous waste or waste oil Froin ether sources.tagme to accept theaddlk' i•charges fordispuial - :•j of this wasre if tho Information t haveprovidod about thtswaste,Is intarre5 I . J (RI1 gerleratorsl'customers MUST react the text and t leckthe assacjated l;ox.) Noy if i iirn a inrge quantity generator,I certlFy Thai have a program In.�face to'reduce the volume and tdOcity of waste generapd to the degree I have determined to he economically praalcable arid'UfSYt have. s Iected t 1 ple method of treatrSici t;'storagerflCdlspusat curmndyavailable to me whlch'mlplmixes the presentand'hrttve Ihneatto humeri tiro and the envlronmentr ter,If lain a small qua+tiny generator,I Ito m cPev good far effort to minimize +gste generation and solea the hest waste management method Shat is avallabieta,me Ihat f can afford. - •- ThE rndlvldual nin In the space Cforif+behrwon behalf of Customer reprosents and-warrants that IWIlle has theauthority m hind Customer,that the fvrgaing dFsoiptknns of wrste and nsaterials are true'a�id accuratcz as ackaged,m r it nd labeled a readyfor.transportatbn In accnrdai tewith appli[26[e stare and federal regyiatione,aril that Customershall abldb and be hound 4y trio Standard Terms andCont�lUorts on the ieverse st f thl4 Sery -e. Date Customer Si at tl!. Date Driver Slgrtature � P, ;1Tt NamL Print Drivers Naii-Ieg — 1 rl e ;