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0 <br />BRANCH SSL CSG 60 Joseph Lima Jr 04/04/14 15:46 PAGE 2 <br />SHIPPING DOCUMENT <br />REFERENCE FOR. <br />CUSTOMERN/GENERATOR: MC22499 MCnellUS Truck 63400500 <br />3100 NAd Art Rd <br />Attn: Ralph Cortez SRVC DATE: 04/04/14 <br />Stockton CA 95215-2218 <br />PHONE 209-931-4282 CONTACT NAME: Mcneilus Truck <br />GENERATOR USEPA ID. CAL000276412 GENERATOR STATE <br />MANIFEST#: 004131506skz FORM CD: 1D SK SHIP# 212813004 <br />TRANSPORTER 1 TXRODOO61205 SAFETY-KLEEN SYSTEMS, INC. <br />5050 SALIDA BLVD <br />SALIOA,CA. 95368 <br />TNSP PHONE: 209-545-1011 <br />TRANSPORTER 2 <br />US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) <br />NON-RCRA HAZARDOUS WASTE, LIQUID <br />(USED OIL) <br />FEDERAL WASTE CODES NONE <br />STATE WASTE CODES 221 <br />TCTAL CONT 1 TYPE IT WT/VOL G SKDOT 11249 <br />CNT#: 140328497732 SZ: BULK VOLUME CONTAINER QTY: 200 PROFILE: D150105CA CAT CODE:A <br />DESIGNATED FP.CILITY NAME/ADDRESS: <br />SAFETY-KLEEN OF CALIFORNIA, INC. <br />6680 SMITH AVE. <br />NEWARK CA 94560 <br />TSD PHONE: 510-795-4400 <br />FACILITY USEPA ID NO CAD960887419 <br />FACILITY STATE ID NO <br />If high risk source, SK rep. certifies that load specific PCS & <br />Silicon testing have been completed prior to pumping this load. <br />GENERATOR STATUS <br />CESQG: Vehicle <br />Customer certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />for transportation according to the applicable regulations of the <br />Department of Transportation and (ii) no material change has occurred <br />either in the characteristics of the waste/material or in the process <br />generating the waste/material. Customer agrees to pay the above <br />charges and to be bound by the terms and conditions (1) set forth in <br />{a) the General Terms and Conditions provided Separately to Customer <br />or (b) any SK agreement signed by Customer and SK, and (2) <br />incorporated herein by reference. Unless otherwise indicated in the <br />payment received section, SK is authorized to Charge Customer's <br />account for this transaction. Customer certifies that the individual. <br />signing this Service Acknowledgement is duly authorized to sign and <br />hind Customer. The following provision is applicable to Safety-Kleen's <br />parts cleaner and paint gun cleaner services: Customer agrees that it <br />will not introduce any substance into the solvent or aqueous cleaning <br />solution, including without limitation any hazardous waste or <br />hazardous waste constituent, except to the extent such introduction is <br />incidental to the normal use of the machine. Customer further agrees <br />that it will not clean parts/paint guns that have been contaminated <br />with or otherwise introduce polychlorinated biphenyls (PCB's), <br />herbicides, pesticides, dioxins or listed hazardous waste into the <br />solvent or aqueous cleaning solution. Safety-Kleen has the capacity <br />and is permitted to accept, store, and/or reclaim the spent parts <br />washer solvent; paint thinners, solvents and paints generated by <br />customer; or dry cleaning filter cartridges, powder, and still <br />residues containing perchloroethylene, petroleum naphtha, or <br />triflurotrichloroethane dry cleaning solvents. Customer agrees that it <br />is responsible for properly classifying its waste streams as Used Oil <br />or Nonhazardous Waste in accordance with the provision of 40 CFR <br />Page 22 <br />k�ECEIVEL <br />AUG 0 7 2015 <br />ENVIRONMENTAL <br />YFA!'W r1a0AoTiACPIT <br />