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FORM NO.AES003 <br /> SERVICE ORDER <br /> NO. N 9026007 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE a COMPTON,CALIFORNIA 90221 ❑ (310)886-3400 <br /> EPA#CAD028277036 <br /> DIXON UNION CITY CHICO FRESNO. <br /> 88r00-727-2879 888-603-8844 800-733-9043 866-994-6937 <br /> DATE �r 11-1 / ONETIME PICK UP DYES or❑NO <br /> vi� <br /> CUSTOMER / AliG iz<sFh+ RESIDENCE DYES or❑ NO <br /> BILUNG ADDRESS CONTRACT CUSTOMER ❑YES or❑NO <br /> PLEASEaPAY FROM-THIS <br /> /+ SERVICE ORDER�, <br /> PHONE 15: Y/�93 J�] � CONTACT CUSTOMER NUMBER l/.5 40- <br /> CUSTOMER EPA,# CAL c 3���I AMOUNT <br /> JOB SITE ADORES$ ._7�3/��� ✓'A--MAC,l AG 7 �CJ � CHECK NUMBER <br /> 1 l>6� c-A 90—n P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT( <br /> NOTES, COMMODITY I-) l <br /> HALIDES P.P.M. <br /> NON-RCRA HAZARDOUS WASTE,LIQUID(USED OILJMIXED OILS)STATE CODE 221 <br /> 'Nd PLACARDS REQUIRED- <br /> 0 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE <br /> *NO PLACARDS OR MARKINGS REQUIRED- NEXT SERVICE DATE <br /> ❑ OTHER I DRUMS DRU`fMSIZE <br /> MANIFEST NO. NO.OF GALLONS ,✓ <br /> DRIVER �_ �h-d(Ip TRUCK NO.&RT. Q <br /> ❑ USED OIL AND GASOLINE FILTERS <br /> ❑ SA RECYCLING, 33210 Western Avenue,Union City,CA 94587 1-510-487-9277 <br /> ❑ ALTERNATE FACILITY <br /> DESIGNATED TSDR ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scot Averue•Chico,CA 95928•CAL000827844 <br /> * ASBURY ENVIRONMENTAL SERVICES-CHICO II,LLC•1618 W.5th SL,Chico,CA 95928•CAD980694103•(600)733-9043 <br /> * ASBURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr.,Portuna,CA 95540•CAL930256136-(B00)733-9043 <br /> ❑ BAKEFISMELD TRANSFER INC. •1520 E.Brundage Ln.•Bakersfield,CA 93307•CALOOD28259B•(661)377.0308 <br /> ❑ D/K DIXON•7300 Chevron Way•Dixon,CA 95620•CAT080012602•V07)693-6008 <br /> ❑ DEMENNO/KERDOON•2000 N.Alameda Stroot•Compton,CA 90222•CAT080013352•(310)537-71(30 C <br /> • EVERGREEN ENV.•4139 N.Valentine Ave.-Fresno,CA 93722•CAB982a46982•(510)795-4400 r,-;a � <br /> ❑ RAMOS ENVIRONMENTAL•1515 S.River Road•W,SacramarRa,CA 95591•CADU44003566-{916)371-5747 <br /> ❑ WORLD OIL-SAN JOAQUIN,LLC•14287 E.MeP ing Ave.•Parlier,CA 93648•GAL000102751• 9 40 <br /> ALTERNATE FACILITY t <br /> USED OIL,USED AYMFREJZE AND OILY WATER WASTE STREAMS ARE Tnis Is Io cw0V trial The above named w6des ore assified,desadned.pmkaged,mms ed <br /> RECYCLED AT OUR SISTER COMPANY DEMENNOIKERDOON THE F> NY classified, <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. and labeled,end 9rin p in b cdWlTkn for Iian4perlaGan,acrording to owappUceble regulellans a! <br /> lila Oaparfman!of TransporWGon. <br /> rl HEREBY CERTIFY A THAT!HAVE NOT ES ARE <br /> THIS WASTE WITH ANY / f/'") <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 RPM.: X /i/jJ�- <br /> AND THRTTHE WASTE ODES NOT CONTAIN ANY PC.6'5-. G71 µER S$GNAAYU`RE <br /> •1 FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL <br /> DISPOSAL IF THIS WASTE IS OVER 1000 P.P.M.TOTAL HALIDES,OR X �� 12,4 T �� <br /> CONTAINS ANY P.C.R'S, PRIN NAME <br />