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CSG SK-SSL-Box-23 Raymond Gomez 10/08/18 14:05 PAGE <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR. <br /> CUSTOMER#/GENERATOR: 5027286 Southbay Auto Auction 7816361( <br /> 4101 S Airport Way <br /> StocktonCA 95206-3909 <br /> PHONE 209-263-1706 <br /> GENERATOR USEPA ID. CAL000386339 GENERATOR STATE <br /> MANIFEST#: 006777837SKS FORM CD: 11) SHIP# 226696192 <br /> TRANSPORTER 1 TXR000081205 SAFETY-KLEEN SYSTEMS, INC. <br /> 5050 SALIDA BLVD <br /> SALIDA,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, SOLID <br /> (DRAINED/UNDRAINED USED OIL FILTERS) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES <br /> TOTAL CONT I TYPE OM WT/VOL P SKDOT 7872676 <br /> CNT#: 181003113233 SZ: SS GAL/205 L CONTAINERS QTY: 2SO PROF# 156033 <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> THERMO FLUIDS INC <br /> 12533 SE CARPENTER OR <br /> CLACKAMAS OR 97015-8988 <br /> TSD PHONE: 503-788-4616 <br /> FACILITY USEPA ID NO ORQOOOOZS197 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 0-220 lbs/month <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 (ii) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material, and (iii) the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to be bound by the terms and conditions (1) set forth in (a) the <br /> General Terns and Conditions provided separately to Customer or (b) <br /> any SK agreement signed by Customer and SK, and (2) incorporated <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section, SK is authorized to charge Customer's account for <br /> this transaction. If Customer fails to make payment when due, an <br /> amount equal to the lesser of (i) 1.S% per month (1896 per annum or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the individual signing <br /> this service Acknowledgement is duly authorized to sign and bind <br /> Customer. Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law. The following provision is applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br /> agrees that it will not introduce any substance into the solvent or <br /> aqueous cleaning solution, including without limitation any hazardous <br /> waste or hazardous waste constituent, except to the extent such <br /> introduction is incidental to the normal use of the machine. Customer <br /> further agrees that it will not clean parts/paint guns that have been <br /> i contaminated with or otherwise introduce polychlorinated biphenyls <br /> (PCB's), herbicides, pesticides, dioxins or listed hazardous waste <br /> into the solvent or aqueous cleaning solution. Safety-Kleen has the <br /> I <br /> ------- CSG SK-SSL-BOX-23 Raymond Gomez 10/08/18 14:05 PAGE 1 <br /> CSG SK, <br /> I , <br /> GI CUSTO o <br /> 0 <br /> C <br /> c GENE <br /> f MAN] Signature <br /> D Th,g <br /> e <br /> 9 CUSTOMER / GENERATOR: brian neylon <br /> G <br /> a Th <br /> G <br /> t <br /> us <br /> F <br /> Signature <br />