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FORM NO.AESM3 <br /> SERVICE ORDER <br /> No. N 9054152 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVFNUE o COMPTON,CALIFORNLA, 90221 n (310)886-340f3 <br /> EPAlt CA0028277036 <br /> DIXON UNION CITY CHICO FRESNO <br /> 800-727-2873 688-603-6844 800-733-9043 866-994-6.937 <br /> IDATF- 6) ONE TIME PICK UP DYES or F]NO <br /> IA <br /> CUSTDMIER F-T ("0 4d C RESIDENCE 0 YES or 0 No <br /> BILLING ADDRESS r CONTRACT CUSTOMER �F-S or-0 NO <br /> PHONE-2-0—5 J' lkP CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA fi. AMOUNT <br /> JOB SITE ADIDRESS:�&:3,5' 4L— ?2-Y ce::j,g2V,5 If CHECK,NUMBEfl <br /> P.O.NUMBER <br /> ' <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES: COMMODITY <br /> HALIDES Rpm <br /> ON-RCRA HAZARDOUS WASTE,LIQUID(USED OILIMIXED OILS)-STATE CODC, 221 <br /> *NO PLACARDS FAEQUIRED* <br /> 0 NON-RCRA HAZARDOUS WASTE,LIQUID(EFHYLENE GLYCOL SOLUTIONS}STATE CODE J, <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> 0 OTHER DRUMS DRUM SIZE <br /> MANIFEST NO, AJ 7 7 I'lNO,OF GALLONS ll�— M t <br /> DRIVER 4?� I -RUCK NO.&RT. 41e)N /7— <br /> 0 USED OIL AND GASOLINE FILTERS U 2017 <br /> 0 SA RECYCLING, 33210 Western Avenue,Unbirt City,CA 9458 <br /> 0 ALTERNATE FACILITY. <br /> DESIGNATED TSDR Cl ASBURY ENVIRONMENTAL SERVICES-2549 Scot Avenue Chico,CA 95928•CAL000827844 <br /> * ASBURY ENWRONMFENTAL SERVICES-CHICO 31,LLC-1618 W.5th St.,Chicb,CA 95928-CA0980694103-(800)7334043 <br /> * ASBURY FRVIRONMENTAL SERVICES-FORTLINA-200 Dinsmore Dr.,Fortuna,CA 95540-CAL9302561 36*(800)733-9043 <br /> El BAKERSFIELD TRANSFER INC. -1620 E.Brundage Ln..Bakerwilefd,CA 93307*CAL000282596#(661)377-0308 <br /> El D/K DIXON-7300 Chevron Way*Dixon,CA 95620-CAT080012602-(707)693w5008 <br /> El DEMENNOIKERDOON*2000 N.Alameda Street*Compton,CA 90222-CAT06001 3352-(310).537-71 OC <br /> 0 EVERGREEN ENV a 4139 N.Valentine Ave.-Fresno,CA 93722 m CADS824-46882,-(510)795-44C0 <br /> ❑ RAMOS ENVIRONMENTAL a 1515 S.River Road a W.Sacramento,CA.95591 -CAD0440OS556-(916)371-5747 <br /> Cl W 01L-SAN JOAQU N,LLC-14287 E Manning Ave -Parlier,CA 9:3645-CAL3001 02751 •(55498-0240 <br /> -ITI: <br /> RNATE FAGI[JTY r-n 3,f — rA- <br /> STREAMS 4RF- This is to certify that t( fl e pz�l rr�a <br /> USED OIL,USED ANTIFREE�r=.AND OILY WATER-WASTE acZ ar y <br /> ECYr-L ED AT OUR R S I STER COMPANY D FM E N N OIKE R 0 00 IN THE � <br /> and LabelL�d,and are in proper condition or transportatuccra 5 applicable reguie'vons of <br /> H I I;E,aoccwid�'nn <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. the Department arTransportation. <br /> Al HEREBY CERTIFY THAT i HAVE NOT MIXED THIS WASTE WITH ANY X <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; <br /> AND THAT THE WASTE 00 ES NOT CONTAIN AN Y P.C.US- CUSTOMER SIGNA71JAE BATE <br /> ,I FUR74ER AGREE TO ACCEPT THE ADDMONAL CHARGES FOR LEGAL V <br /> DISPOSAL IF THIS WASTE 19 OVER 1000 PRM,TOTAL HALIDES, DR <br /> CONTAINS ANY RC.B'S, PRINT NAME <br />