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R, os Environmentai %servic RECEIVE® <br /> 1515 South River Rd. <br /> West Sacramento, CA 95691 MAY 0 7 2014 <br /> (916)_371-5747 <br /> CAD044003556 ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> SERVICE <br /> SERVICE ORDER ORDER NO. <br /> BILL OF LADING <br /> JOB NUMBER <br /> DATE — <br /> GENERATOR GENERATOR-EPA# <br /> BILLING ADDRESS----- <br /> AMOUNT <br /> DDRESS; -- AMOUNT(IF ANY) <br /> GENERATOR CONTACT _ CHECK NUMBER <br /> PHONE P.O. NUMBER . . <br /> JOB SITE ADDRESS:. j C CASH RECEIVED :(amt.) <br /> — --- HALIDES P.P.M. <br /> JOB DESCRIPTION <br /> MATERIALS <br /> START TIME <br /> NON-RCRA HAZARDOUS W ASTE LIQUID, (USED OIL) CODE# . <br /> ARRIVE TIME <br /> NON RCRA HAZARDOUS WASTE. SOLID-LIQUID CODE" LEAVE JOB <br /> ❑U.S.DOT DESCRIPTION: STOP TIME <br /> (USED ANTI-FREEZE)NON RCRA HAZARDOUS WASTE LIQUID CODE# USED OIL FILTERS DRUMS. <br /> - tri. <br /> MANIFEST.NO. ,- t _ t NO.OF GALLONS <br /> DRIVER'S SIGNATURE` TRUCK#: ti <br /> DESIGNATED TSDF-RAMOS ENVIR .MENTAL SERVICES 1515 SOUTH RIVER RD.WEST SACRAMENTO 95691. CAD 044003556 <br /> I HEREBY CERTIFY THAT.I HAVE.NO MIXED THIS WASTE WITH ANY OTHER WASTE,AND THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M. <br /> This is to.certify that the above named-articles are properly classified, described, packaged; marked and are in proper. condition for <br /> transportation,according to the appli able regulations.of the Department of Transportation. <br /> Generator's Certification:I certify that 1 ave a program in place to.reduce the volume and toxicity of waste generated to the degree l have determined <br /> to be economically practicable.Ramos agrees with the generator to send all their hazardous waste to an authorized hazardous waste treatment facility <br /> via Ramos'standardized permitted stoge facility: <br /> All used oil collected from the generato listed above will be transported.only to.a facility permitted by the.State of California to accept used oil. <br /> Terms-net 15 days:. <br /> After due date,a finance charge of 1:5 %per month,18.00%annual rate,will be charged_on the unpaid balance.The customer agrees to pay reasonable <br /> costs and attorney fees incurred in-the ollection of this obligation.Venue for purposes of enforcement of this obligation shall be Yolo County. <br /> I declare,under penalty of perjury that I he foregoing is true and correct. <br /> x <br /> GENERATOR SIGNATURE <br /> 24 Hour.EME rgency Response Team: -800-456-774a <br />