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SERVICE OR%ER
<br />FO IsEFRv, CALL:
<br />PARLIEP ARBURY ENVIRONMENTAL SERVICES, DESA
<br />� f
<br />559-498-0240,
<br />FOP ACCOUNTING CALL:
<br />562-231-1550 t,
<br />��i�v i Vr1iiC��.C�tOIL MENTAL
<br />147 7 EAST MANNING AVE, PARLIER CA 93648
<br />i 559.4a34'i 240
<br />,r
<br />"I RLDOIL.CORP.GOM
<br />TRANS RTER FPA # CAD028277036
<br />FORM NO, OIOE`004 n ra/17)
<br />SERVICE ORDER NO,
<br />DELTA '°df I(,,�<' f
<br />CUSTOMER #
<br />PURCHASE ORDER #
<br />ROUTE #
<br />TRUCK #
<br />CONTACT NAME
<br />ORDER TAKEN BY
<br />HALIDES
<br />7
<br />7T 7t
<br />BILL of LADING/MAN'11`F S T V
<br />DATE REOUIRED
<br />DATE ENTERED
<br />NEXT SERVICE DATE
<br />CUSTOMER EPA #
<br />QTY
<br />J.
<br />CITY P/! J
<br />PART #
<br />DESCRIPTION
<br />UNIT PRICE
<br />sV, 'r�A
<br />. Ei.14d6 4AT ,:11`4 0.. 4. t S :>
<br />Yry,,.J=J ,
<br />gyrm �(���,y� ��g��. �..�, �y �fl�
<br />i,� •i tN v, '1 R' q?4YYFs �'9 'T!'l4Yt 6i� 'M'S^? A Plug' andatt�R �t7Yi 911 V1t�ini (II+((4WA Ft'r1•'1� �
<br />F� y� y� �3
<br />:4:� Yeli�-Y `V'L#.%j4
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<br />;•Ix ,f:
<br />,r>cI rh izra !ref tht aMhoifsq r; R2€� } AVK b4ftl 4XIMi
<br />CASHCH _-__-.,w._.__..______...._.."..._...._.....,.
<br />WASTE DISPOSAL INFORMATION
<br />NON-RCRA HAZARDOUS WASTE, LIQUID (USED, OIL/KAIXED OILS)) STATE CODE 22;
<br />NON RCRA� STATE CODE
<br />t �NA }liI
<br />OTHER:
<br />DESIGNATEDTSDF:.._..__.----'---.
<br />s^
<br />Flt:j (RNAT TSi,. �;, mp-
<br />DRUMS PAA _ ...d .. _ EMPTY DRUMS:- ..... FACILITY; .. _.... BSC......_.
<br />r77—
<br />C ENI-HAi CJH WAu I t C_tK i it-li At iUJN (t'Ltta7t I—Mv N I ME, rtr rnvr M-1 L. 111,1n/
<br />i?Y siri.u;g Ue:'v v!'earoby�o'nrty teal.
<br />(Waite oil generator/customer MUST check ONE of the following three boxes;
<br />-a .::have n:•t ^ixea ry f ne waste ries. ;bed �" ove wits ary o he' hazar8ous waste, Ute tot haute r:ortent is LESS Jar. 1,1000 own. and, the waste dues u)t ccrtaT, Iry q ) ( ( - � �• '
<br />m 3f 1) m a:) (p-f(yx:''a l , P . (Odr a(l i nPltt ir•J Iasi nS t dote Gl{(to ihl5 s Yr f l aJ4te'o attpot the ,dditl-anal , .)rt, yC. ,t)r lip (i,spo••n � ti d tva :,L ii t . , p(7�t, ( l h . (t;,i.• 1.. • ,II ,
<br />:.avr not rrnred ar,y flf the vasif d(.x Wed al n e w1th ariv 01"P? hazardous waste the o -. haldc ron,en* Is Cki.z E'('han !.COO ppn), and i le want - 01's s r; <01ta. r. wl, ri .
<br />Yhr.leer,:'tdp•opetdocurnentat;ontoYWof!c!0I.ni orn)£,,;i!Se,v'm o{,.vul11v' estimpt.on,Nt.rs,va,TI?Was.t xY.(l+witholhulNizaldowwast., ),Im:oa,(Cp!lipt. .•. ,.:,,,
<br />Kaife'.f tfir. Information 1 have Gl ovided about IN, waste: is ln;,orect
<br />xaih r, ; wastf l•• (mm at ank tuhith roliects waste oSi from huasehc d'dn tt-youtse!f'd7v} and/Or tendit7nnatiy Cx?mpt srnAii nu-inbty generat<,, KTB c, —kvoes In h e t r `I
<br />• ,v USP/ <.f SCG cottec lot, fa^• Is >mav ro n v'v and/or CESOG sources i have not ml.ed th?, ware off with an• wh • hazz"dov,. waste (r w8ire o .. fro'. o.,l% ' .r" (..: i:,gree •. , p, I! ,.�.
<br />ft! Ct1�y'.'i:5te :: •F+A �Ylt(JIr-1a i�,)n i tla'�f CI r:)v.afd a::�f.il'. ♦h I'• N'a5fe :s .nCoir.+fi
<br />(All generators/ customers MUST read the following text and check the a�So tate el box.)
<br />(``y..i6•i: U I lln, d iarsje tY++,ttythey a}RnLtJtrit ! crt ofs' !t'at Rvv+' R yi(€ tl to pt ,1)a S di 7tuttFCYdt)+f• a)htrn;• Jit f t tGttq pf t c )r"N' tt A Shm de "Y , e 4 Furse tJ YM.: -d P I V ,�a,l I 11. f r 7 ' '.
<br />llh lrrY rl1r FraUtL'a}IP rwrH4hnd+s`EC(:+a+tnh9r"+t strtta[,}t+. flY Ptia"IUt nt i.cmtynifv �vdti.( o tntT1n•.±hirli l wIftliN-1 t9t P, 11)1,0 .1144 .ub thn�.st t/: hutta�17 f111 Intl the env lei+.f�r+(it C. W
<br />nail:.t.rd",cood fa,thefrn'tit, avrr: r th u'.CI w,r[ r'vj,,,JNRtr..x vlfitttt7=,f r.?24.i:•rii5}rt ^,r!I•th•f-,n.affr
<br />TO .,'i `:lii,i;1 t7".:nry l! .I,++ tl,.t: a tr•t torllh and — tarts th,lf n( /$Ile I,s t{ ., aril,"illy tt, bita C. stofrlei that ii\ if tY i.' ie (r'v I7n
<br />.+ ;1. t d a!•r, upla'd, are'esdy !o: clan ,c-t.l...a :. areorra! s.• o -.µft spp +Fvi...,ate a .1 foe.,-,- n,aw l nr , •):,.i Ow, l .,,^u- shell :00& v 1 Uc, :- .o ! -r l(s, , , � • _ _
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<br />f`"4,f TGA"st'f �i�tai'3tlJ its
<br />Date
<br />D{ Ivc f t�tLl�ilatUti'
<br />Print Drivers Namc.,
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