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FOR <br /> IEE E_:DIXON OFFICf w ,. FORM NO aEU4-g rPFv 10107) <br /> SERVICE ORFEkN <br /> UNION CITY OFFICE <br /> 1-888-603-8844 <br /> CHi(-30 OFFICE1 <br /> 800-733-9043 f <br /> ASBURY ENVIROOWNM SERVICES <br /> j a1 };OUT NTA,g PE,CC"P"FOK CA 90221 <br /> 1Y W 00 <br /> TtltPA 4 CAE 26277036 <br /> n t , <br /> n <br /> 3 <br /> CUSTOMER E�t1. R `",. - ! T t RC R T Y HALIDES <br /> E[9E <br /> i� <br /> 1 E E; MANEEzE� T#4 <br /> a. xA, ,.t r <br /> d <br /> PART# <br /> h} <br /> y <br /> l # ; E`7 Eli�ET E� iEE�E QTy PtiJ f?fi E ..k <br /> ! } <br /> 1111715 <br /> � RAM , <br /> 3F <br /> ITOT <br /> � t i <br /> P <br /> A <br /> tura � ASE Y� SORDER M .. <br /> n <br /> NON-RCMHAZARD IM-10-ulkEW STAT C 22"1 <br /> E CODE <br /> REQUIREW STAT <br /> S G AT,ED SDE"ALTERNATE TSDF: <br /> e <br /> g <br /> .,. ., <br /> A RECYCLING: . <br /> DRUMS-PIU: BBC <br /> =is is les r ert;fy that the waste va as bpd d .'� r Condition for transportation,accord!og to appaica State <br /> ?Hca tis:oral re9wahons, y signing:b <br /> OF <br /> °-�4l i#have not mixed any of the, Woos ribald ale v I�a4 A�P't�w*ca�u� �qo-tbR�3, da�q,Ctta h+4, '`f. 'S-'rhan 100,PPM,a.+d tmb waste d nmt rat in�.ay POS...9.h.— <br /> €�bmpfred with the requirements of:t "cab4ti C� r� i <,� " s t d t „� .t" to accept the;additional:etaarges.for 44le disposal aT'this waste <br /> if the information l have proaidad`,: `�.tE3ls�+s#tJEr,' tCR._ v .. <br /> s:<` t <br /> G ,tl l Paave nest rnixad any of tla®Y€�a a�ssCxataad shows t .fit art r' :# d{pp ttt";�, Gt�aA than 1,060 pPfta,and the to doses ri®t contain any POSS.i <br /> brave prixvided pr don mentatibn, bury v .t .w,alta _. of hazardous waste:i to accept the' 'botaal Charges <br /> for tits clispoal of this wivasts <br /> p 0 i This waste is from a tang¢whip its waste ajl,frsan It d; yot4t �t Y-I artdlor a inttattysaltempt smaa it quantity generator tGESQEii sagurcea{ass tate Brest of my <br /> knowledge the only wageoil r ?st� iAiY� fie. � - ,i ,Rot mix this waste asci with any-o hazardous waste or <br /> waste oil trosse.sather so to",i agree It tss n � �t 1 g tov ded about than waste is incormt <br /> l <br /> ` J if l am x} gu h snotat k e 4 , ar �Y fN atadto 'res i hav®- rent to be economically <br /> bra 3xhat t lsas7a x 4 pr9sSi c sf#ty #as a6hgeh ttvressnt and#mteee thveat to notion life and <br /> tfae e vironsnaiztt, T.it.L o s6a9at}. g ua4 J a Y �t F Rak 1 ,ta i4ft+to €ev iStO prtd select#ta best"sate massa enaent eaatggtxnse that is avail able <br /> toone l`fS,a431 c$f@ <br /> �. <br /> t <br /> r' <br /> e <br /> ate <br />