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FOR 4ERVIGE CALL: SERVICE ORDER FORM NO. 4NOES'OO9-B(8/l bj <br /> Glxory OFFICE AS6URV ENVIRONMENTAL SERVICES, OBA <br /> �-HOUO2T-28J9 SERVICE ORDER NO. <br /> FOR ACCOVNTING GALL paI®�6�V ®�y N2791465 <br /> 562-2a1-155U ^l!tl` �6 ie <br /> ENVIRONMENTAL SERVICES,.. <br /> GHEV RON WAY'O:XON,CA 95S2U <br /> JIFFY LUBE S59$ Jano zx BROAOBASE INC- BR0009 <br /> '1130 N. MAIN STREET wwW.WogLIjOILCOR ROOM '1471 SHORE STREET <br /> - MONTHLY BILLING WO S.OF TRAr3PORTEq EPA a cA0U2S2PYUa6 <br /> MANTECA.GA 85336 WEST 3AGRAMENTO.CA 95697 <br /> =' (209)239-0665 � (B1 B) 375-7155 <br /> C7! <br /> CUSTOMER M PURGH45E ORDER C ROUTE uC TRUCK i CONTACT NAME OROEq TAKEN BY HALIDE$ _I <br /> JIFB68 LITE 124 4Qo1 OOUl3 SCHEDULED-O <br /> OgTERE0U1RE0 GATE ENTERED NEXT SERVICE GATE CUSTOMER EPA< ILL of LAOINS/MANIFE$T8 <br /> 1/28/2079 7/222019 GALAUOO11 O32 <br /> /Gf3 X5565�� <br /> PART M DESCRIPTION QTY UNIT PRICE OTV P TO AL <br /> ^d OLJ <br /> I <br /> 9M1TCH i <br /> TOTAL. � <br /> CASH RECO: CHECK# <br /> WASTE DISPOSAL INFORMATION - <br /> NON RCRA HAZAROO VS WASTE.LIOVIO(USED OILIMIXEO OILS) STATE CODE 22l <br /> NON RCRA H42AROO VS WASTE.LIOVIO (ETHYLENE GLYCOL$OLUTOryS) STATE CODE <br /> OTHER- <br /> Y. OESIG NATEO TSOF: _ASBVRY ENVIRONMENTAL ERVICES ERES 192Fl MORi_t2,iiC ERES,CA l5 S�_HB]$J B2v QALVU03flyAa <br /> ALTERNATE TSOF-. qm uptM :uOM ScT Rwd <br /> Q1LpK14gj�0_F�.SL24/1ZOK oIXON_ _ _ — .. ._ <br /> OgVMS PIUv EMPTY DRUMS: CILIT Y:_ BSC <br /> GENERATOR WASTECERTIFICATION (PLEASE OHECK THE APRROPRIAT BWL.B ) l Z�).3. <br /> (Wast®oil ga aior/c sto r MUST ch ecK ONE oT tFa tcliowing thr e b s) <br /> ��,. a %:2iro..o o��"_ <br /> b,o...e..�e..�.oe.,,e...,�....e....��e.,,,e.m...o�...e_.o.o...ase�m......=...e�.e,_�..�...._�. <br /> •����e+.....o...v.. �m�r...:.mrne.eeino^^(All ge u�c ators/c s[omErs MUST r,o ad tM1e folio•o�ng text <br /> _.,..tee.,...� ',....`^ f.d:._�u,.�o.a.:�Z>'al�"�e�K=_^,aoN,e.ro�."DAu e�...e�e�oun�,..�e....a...,amne._EP.�n.�.6 o^6..N._.....a..�—/ ��' Z`Y' <br /> seo s.9 oe'e � Dale <br />