Laserfiche WebLink
FORM NO.AFS7h1�i <br /> SERVICE ORDER <br /> - - o. N 9054152 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 13.00 S,SANTA FE AVENUE D COMPTON,CALIFORNIA 9022 r n (310)886-3404 <br /> I=PA#CA0028277(136 <br /> DIXON UNION CITY CHICO FRESNO <br /> 800-727-2879 888-603-8844 800-733-9043 8Q6-9946937 <br /> [TATE ONE TIME PICK UP DYES or ONO <br /> CUSTOMER 6'�, _ RESIDENCE ❑_YES or"❑ NO <br /> BILLING ADDRESS <br /> CONTRACT CUSTOMER ES cY•❑'No <br /> ilk <br /> PHONE-7—G I 10P CONTACT <br /> CUSTOMER NUMBER ka 456� <br /> CUSTOMIWR EFA t���.�'T / ���o�• � 4c�.J�`I, AMOUNT <br /> JOB SITE ADDRESS'- ` a c, - u5 c CHECK NUMBER ' <br /> !3 G> RO.NUMBER <br /> CROSS STREETS "CASH RECE_1VED <br /> (AMOUNT) <br /> NOTES: COMMODITY lJ`' On <br /> HALIDES P.P.M. <br /> '90N-RCRA HAZARDOUS WASTE,LIQUID(USED OIL/MIXED OILS)-STATE CODE 221 <br /> *NO PLACARDS IREQUIRED* <br /> E) NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE . <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> ❑ OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. <br /> � �� _^. � �_��� NO.OF GALLONS � <br /> bad C� �I <br /> DRIVER (J p TRUCK NO.&R7 D U <br /> © USED OIL AND.GASOLINE FILTERS U z0 1 r . <br /> ❑ SA RECYCLING, 33210 Western Avenue,Union City,CA 9458 $ 4;487-9277 <br /> © ALTERNATE FACILITY, <br /> DESIGNATED TSDR D ASBURY ENVIRONMENTAL SERVICES•2549 Scot Avenue•Chico,CA 95928•CAL000827844 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES-CHICO 11,LLC■1618 W,5th St.,Chico,CA 85928-CAD990624103•(SCO)733-9048 <br /> ❑ ASSURY ENVIRONMENTAL SERVICES-FORTUNA•200 Dinsmore Dr.,Fortuna,CA 95540•CAL930256136=(800)733-9043 <br /> p BAKERSFIELD TRANSFER INC. •1620 E.Brundage Ln.a Bekersfiefd,CA 93307•0AL000282598*(66t)377-0308 <br /> p D/K DMON•7300 Cheveoq Way•Dixon,CA 95520-CATUB0012602•(707)693-6008 <br /> p DEMENNOIKERDOON•2000 N.Alameda Street•Compton,CA 90222-CAT080013352•P1 0)537-7100 <br /> ❑ EVERGREEN ENV.•4139 N.Valentine Ave.-Fresno,CA 93722•CADB62446882.•(510)795-4400 <br /> ❑ RAMOS ENVIRONMENTAL•1515 S.River Road•W.Sacramento,CA 95691 •CAD044003556•(916)371-5747 <br /> .CI WQQLD OIL-SAN JOAQU N,LLC-14287 E_Manning Ave.-Parper,CA 93648■CAL000102751 ■(55 498-0240 <br /> Tt=RNE AGILITY <br /> AT <br /> USED OIL,USED ANTIFREEZE AND OILY WAMR WASTE STREAMS t3E � � ���� <br /> RECYCLED AT OUR SISTER COMPANY DEMENNO{KERDOON THE This is to certifythat 1 . a ov name a c sr ers as f+e e d, ao <br /> LARGEST REGYCLER OF USE OIL IN TttE tll+EsT6�iN LtNlTED STAT)S. and Oa5eled,and are in proper condition for tran-4portairon,aca rd Ing to the applicable regulations af' , <br /> the Department orTranspprtatEnn. <br /> *1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY PC.B'S.. CUSTOMER SIGNATURE DATA <br /> "I FURTHER AGREE TO ACCEPT THE At7t7MONAS,CHARGES FOR LEGAL X r ti <br /> D[SPOSAL IF THIS WASTE IS OVER 1000 RRM.TOTAL HALIDES, Dpi C_J <br /> CONTAINS ANY P.C.S'S. PRINT NAME <br />