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FOR SERVICE CALL: SERVICE ORDER FORM NO WOES004-B(6/l B) <br /> DIxoN OFFICE ASHURY ENVIRONMENTAL SERVICES, OHA <br /> l-BOO-727-2099 SERVICE ORDER NO. <br /> N3555187 <br /> FOR ACCOUNTING CALL: ®WORLD OCL <br /> 5B2-231-Y1�® ������ ENVIRONMENTAL SERVICES.. <br /> •Il 9300 OHEV RON WAY,OIXON,CA 95620 <br /> JIFFY LUBE#ts96 Y-Boo-929-z69e BROAOBASE WG - BR0009 <br /> 1130 N MAIN STREET WWW_woRLDOILcoRRcoM 1471 SHORE STREET <br /> MONTHLY BILLING WO 8 OF TgpNBPORTER EPA#CA00262T/096 <br /> MANTECA, CA 95336 WEST SACRAMENTO.GA 95891 <br /> r2o9) 239-osss [91 B] 375-1155 <br /> CUSTOMER# PURCHASE ORDER N ROUTE M TRUCK N CONTACT NAME ORDER TAKEN BY HALtOF� <br /> JIF668 CER-BB �� DOUG <br /> OgTE REOUIREO GATE ENTERED NE%T SERVICE GATE CUSTOMER EPA# BILL of LAOINO/MANIFEST# <br /> 4/7/2021 cAL000011032 Oz��� t `�7�J3�c <br /> PART# DESCRIPTON OTY UNIT PRICE OTY PN TOTAL <br /> PF PAPER FILTERS PER DRUM 'Z 1/ -�_ <br /> OFOR OIL FILTER DRUM REPLAGEM ENT- NO CHARGE Z �� <br /> BATC! i< <br /> TOTAL <br /> CASH RECO: CHECK# <br /> - WASTE DISPOSAL INFORMATION <br /> NON-RCRA HAZARDOUS WAeTE,L.IOUIO(USED OIL/11111XED OILS) STATE CODE 221 <br /> NON-RCRA HAZARDOUB WASTE,LIOLIO(ETHYLENE GLYCOL SOLUTIONS) $TATE CODE <br /> OTHER: <br /> OE8IGNA� O <br /> ALTERNATE TBOF_ <br /> DRUMS PN' Z EMPTY ORUMSa FACILITY: BBC <br /> GENERATOR WASTE CERTIFICATION(PLEASE CHECK THE APPROPRIATE BOX) <br /> ay agnir,g ee. F br®.I..vms. <br /> (Was[¢ Dii generatoNcuatomar MUST c11acK ONE of iba following ibree boxes) <br /> �.ii.mv. o n.ur� n�m�ie"nTv,�aee y.PYa4�A_e�s4oux_Y^ctfe.,nv.o,alPelMs . W.FE.A�Ii a��-i ve�en. <br /> ....n. .,..� nunenmiwn �- T___ <br /> comyMa v.,F~r7l,.�q,.�anus _ eomaaoem.na...�iiiie n...a.,..,,u,�ni�s i.ua ,o mxaua�,�ow.ewreea m..�,e mcpew e.w.w..,. <br /> O rs♦'�OF�w'nea m�aa affirm n.ewiva_v.�nna eov.wmvnv omc.nay.novc ivv.u.wmw n�.av_am.nab nnra-rcw,nnn.,opo ppm..nvwwuuvm nv.or,mm sm sae� <br /> �Vu;inr Ma rya efrvmeau x,rmm�ce�aiau,a w�sF•,V'pfrvm'n un p�do-o���e��(o�v�a�i,wo.cv„eiuen��®v.o.emn.�q ern miry waw.+.e.Nes��)��Ai,a�ie s�weae.�nl�ww.e�. <br /> n.......,......�.e �s.o...ee.o.me.sem=..u(AII ganeratora/cvatomars MUST read tba following text <br /> �mna..�i.va ee,F:u�.,at��e`.:ae etl u�"+a�i'a�.�v e��i:e.0 m me.4.nia'n mritlm�inn✓rvs'ei,i inn wiaie in�"u.���u�'••��"'.a u�`n.m�..nn n...�ns........s¢,n. <br /> sN ....,.........w�.<��.:':dd:�':®C...��...-:".i.row eA��a'Y.�ow..r.. ..�.w.........�< ..........,.....,...m�......�.. <br /> c.. �gp,�eyre D>.e Dnve sl9n /� ♦a <br /> oma....trema /�Fl� `fd/'1..-+�+�—�, o.....,-.....e..,. .�s� /l_�n��/��=�y�„_ <br />