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FOR ACCOUNTING CALL: v'UC�[�iY t J2$ilii E*A 562-231-1550 AF 110 WORLD OIL ENVIRONMENTAL SERVICES,. H JIFFY LLJi3E#1478 14287 EAST MANNING AVE,PARLIER CA 93648 BROADBASE INC P 164 EL HAMMER {_{�{. 1-559-498-0240 1$71S'{OFZF ST P MON�1'HLY BILIJNG VVO OF WWW.WORLDOILCORP.COM D 5TOCK'170N,( A 95210 TRANSPORTER EPA#CAD028277036 WEST SACRAMEPPTO, CA 956,91 T (916)375.1155 (? o C�)X3:2-87�C/ , CUSTOMER# PURCHASE ORDER# ROUTE# TRUCK# CONTACT NAME ORDER TAKEN BY HALIDES 1JTE 124 t.4bb I SCHEOULED-G DATE REQUIRED DATE ENTERED NEXT SERVICE DATE CUSTOMER EPA# BILL of LADING//,MANIFEST# PART# DESCRIPTION QTY UNIT PRICE QTY P/U TOTAL VVO,'�{: USED GIL.SERVICE CHARGE Wry? USED OIL/MIXED OILS I ORIV€ 5 AdAKE SURE TO LOCK SIDE NATC.H WHal DCXVE l;ra w 5tre0 T O OK DIXON DKIW15¢L ^tV4 XPIRED TOTAL CASH RECD: CHECK# Manager ueve 13.1ruty WASTE DISPOSAL INFORMATION NON-RCRA HAZARDOUS WASTE,LIQUID(USED OIUMIXED OILS) STATE CODE 221 NON-RCRA HAZARDOUS WASTE,LIQUID(ETHYLENE GLYCOL SOLUTIONS) STATE CODE OTHER: DESIGNATED TSDF: r•LL �. �. ALTERNATE TSDF: DRUMS P/U: EMPTY DRUMS: FACILITY: BSC GENERATOR WASTE CERTIFICATION(PLEASE CHECKTHE APPROPRIATE BOX) By signing below 1 hereby certify that (Waste oil generator/customer MUST check ONE of the following three boxes) I have not mixed any of the waste described above with any other hazardous wane,the total halide content is LESS than 1,000 ppm,and the waste does not contain any PCBs.I have complied with the requirements of JJJJ applicable California used oil management regulations to determine this is true.I agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste Is Incorrect j p#21 have not mixed any of the waste described above with any other hazardous waste,the total halide content is GREATER than i,000 ppm,and the waste does not contain any PCBs.I have provided proper documentation to World Oil Environmental Services to rebut the presumption that this waste was mixed with other hazardous waste.I agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect p#3)This waste is from a tank which collects waste oil from household"do-It-yourself"(DIY)and/or conditionally exempt small quantity generator(CESQG)sources.To the;best of my knowledge,the only waste oil contained in my DIY/CESQG collection tank is coley from DIY and/or CESQG sources.I have not mixed this waste oil with any other hazardous waste or waste oil from other sources.I agree to accept the additional charges for disposal of this waste if the information I have provided about this waste is incorrect (All generators/customers MUST read the following text and check the associated box.) #4)If I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have seletted the practicable method of treatment storage,or disposal currently available to me which minimizes the present and future threat to human life and the environment;Or,1f 1 am a small quantity generator,I have made a good faith effort to minimae my waste generation and select the best waste management method that is available tome that I can afford. This individual signing in the space set forth below on behalf of Customer represents and warrants that he/she has the authority to bind Customer,t the for).. descriptions of waste and materials are true and accurateas packaged,marked and labeled,are ready for trans tion in accordance with applicable state and federal regulations,and that Customer sh 6ide and band by the Standard Terms and Conditibns on the reverse side of this Service Order. -y'' tj �Ct)��stomer Signature Date D, rS ignature d Date rift Name Print Drivers Name