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CUSTOMER / GENERATOR: 3, llierme DEC 0 7 2015
<br /> ENVIRONMENTAL HEALTH
<br /> AN
<br /> SHCH SSL CSG BOX-23 David L Buxton 11/16/1S 10:14 PE ItSERVICES
<br /> SHIPPING DOCUMENT �(IJ�'
<br /> REFERENCE NBR.
<br /> CUSTOMLRS/GENERATOR: N026403 North American Sp:eeialty Products G8i51..41
<br /> 300 S Beckman Rd
<br /> Attn. Mike an
<br /> SRVC DATE: 11/16/15
<br /> Lodi CA 95240-3103
<br /> PHONE 209-625-745:1
<br /> GLNtHAIUH UStPA 11). CALUVU38S2Sb GtNEKAfOR SIATIl
<br /> MAN1FtSlX: FORM CD: OP SHIPS 217716774
<br /> IKANSPOHItH 1 1X"000U812US SAtt1Y-KLtEN SYSILM's, INC.
<br /> 5050 SALIDA BLVD
<br /> SALIDA,CA. 95368
<br /> TNSP PHONE: 209-S45-1011
<br /> TRANSPORTER 2
<br /> 6, uui UL:>i ifi'r lief: "jNk L;Jui,,L V4U Lit Ai.IFVIN: N;vL, iiiiAw) CL��i, Aiiu iit)
<br /> DRAINED USED OIL FILTERS
<br /> FEDERAL WASTE CODES NONE
<br /> STATE WASTE CODES
<br /> TOTAL CUNT 1 TYPE DM WT/VOL P SKUOI 14416
<br /> LNI#: 1S11112009b/ S2: SS GAL/LUS L LUN I,t1NtHlo QTY: lUS PHUFrI 1SbV33 L
<br /> DESIGNATED FACILITY NAME/ADDRESS:
<br /> SAFETY-KLEEN SYSTEMS, INC.
<br /> 5050 SALIDA BLVD
<br /> SALIDA CA 95368
<br /> TSD PHONE: 209-S4S-1011
<br /> FACILITY USEPA ID NO CATOW13968
<br /> FACILITY STATE ID NO
<br /> GENERATOR STATUS
<br /> 0-220 lbs/month
<br /> Cuslutner• eertifie� that (i) the abvvc natal1 are properly
<br /> ,lit—Med, po.kwyed, umr'k-I wnd lahrlwl; onI wrr in pruprr' rood it;on
<br /> fur Lratmp.retalion eccurding to the applicable r'eualations of the
<br /> Orlr»r•Imrnl of Trrnsp..rtetiotr entl (ii) n,. n.e!r[•i»1 tltlour has o—'r-4
<br /> eititer ;it the Litaracterislies of the r:as te,�nmtenial ur in Lire p-ute—
<br /> yCr1CI'al'i[[g t11C ..'este/'Itctterlel. Ctistemer egrets to Trey the above
<br /> t barges wnd to br bound by the t«rmis and condiI ion+ (1) set forth ;it
<br /> (a) Lhe General Terms and Curnlitiutu pr•uvided separately to Custuuar
<br /> or (b) any SK agreement signed by Customer and SK, and (2)
<br /> inrnrporated h—in by refer..... Unless otherwise indirat.d in the
<br /> payment received section. SK is authorized to charge Customer's
<br /> ......t for this f.•wosw.l i." Tf fuslno.«.• fails In. Le
<br /> mI.wyuu.nl ...Le..
<br /> du., an amount equal to thelesser of (it. 1.%% per month (18% per
<br /> annum! or (ii) the moo.imam amount oollnw.d by low, ..ill be wdd.d to all
<br /> 'u.....nls .alae»ruling rnsl wiu•r . r•1 Tries tLwl th« ind_idu.l
<br /> sriunmy this Cervi'. Arknnwlwlyrme.1 is duly 4u1hor;-.1 lu ♦Syn wn1
<br /> bind rusto,o The rnllo.inu pr..v is i.... is ooppli .hl. to Cwf«ly-Kleen'a
<br /> parts cleaner and !mint yttn droner > rviten: Castm,:rr• eurres that it
<br /> will reel intra!,.•. w„y +ul•sfrm« 'o't., rbc 10 or w,pt«'.us cleaning
<br /> snlullogo, ioclodiny x.itbout Iiu,;Iof Lm A,.,. 1-0elbn4s waste or
<br /> hazardous taste constituent, except to the extent such introduction, is
<br /> incidental to the normal use ur Live IIIat.h4se. Cu:ftumcr further agree]
<br /> that it a.ill nut clean parts/paint yuns that have been LunLwminatcd
<br /> with or otherwise introduce polychlorinated biphenyls (1/CB's),
<br /> be.•h i.ides, pest it id'.s, dio.i s or 1;.I..I 1.wiwrdou. •w.t« into Ih«
<br /> solvent or aqu.nns rlraning solution. Safety-Klan hoc the raparity
<br /> and is permitted to accept, store, and/or reclaim the spent parts
<br /> x,wsber solvent; 1pw6l thineere, solvents 4 paint. q«n«r'wted Ill
<br /> customer; or dry cleerring filter cartridues, pm•.d.r, and still
<br /> residues runlw in my prr•r hlornrlhylrur, prl rgolrwu nwplJ bw, ur•
<br /> 1.'ifl ur•ulr i,hl or..elhwo. dry .lawnmy solo..!s. nus Lu.u•.• wy rrw Ihn1 it
<br /> �.
<br /> resp.—Ill. for properly .loossifying its waste tr.—. as Ilsed nil
<br /> or Nonhwrardons Wast. in a.co••dance x,ith the pr•wvisimt of 40 CFR
<br /> 262.11 and applicable state laws. Custunler agrees that it will not
<br /> 6tr•v11ece any viol'-conforming subslwn'« int'. the SK property,
<br /> ;o' J, will.....1 1; ;1.1inn; wny h—rduu, ww.lr .r hw.wrduus wwsle
<br /> cunstittlent,(i.e., polychlor'inatetl biphenyls ("P2ts"), herbicides,
<br /> pest i.ides, d6.4o" lir 1 isf rJ I.—r'duus w slrs;y r 'rpt In Ihr r.lenl
<br /> snrh inlrudu'th". is inridrolwl to Ihrn rm.1 u'r of Ihr SK Pruprrty.
<br /> In the evelA of the ivit!•vduelion of sloth'rflun-c..•efvr!nitty 11a_erilmit
<br /> xwste, rua.u.wr aurrr that it will 1_ .ih1. Int' all '_t. .'al
<br /> rrwrJ iwl Tun r.pe s rrlwl rd In or wris iuu'rru.0 Ihr p.aper wyrnrnl
<br /> arld disposal of Lhe non-tunfvrin., mast., inelso41nU the tvstwur
<br /> equipment. dewnlwminaLiun and subsequent dispusal. Final iuvuiLivy
<br /> will be 6o—d on the attuel srrvitrs ,provided, •.4,iah !nay in.l..d.
<br /> ».Id it i.aal 'Irwr�«. for off sl..';fi,.1 ion x see ..god . •.h»rg« F:.wl
<br /> 640 'smnrol may be nmre Ib.n ond th. .... ..I 1;,l. on to'. prim«
<br /> .rript Tf wny legal .,lion . .mnuem r.l 1-4as. of ... wt.1.'Jed
<br /> dispute, breach, default or Illi-rrpraentation, the Custcaner• also
<br /> agrees that the prevailing pwr'ty will be entitled In r•r'over
<br /> reasonable etturney's fees and costs associated with the
<br /> ...to-.ago Fu rw inu got wm inwf i.... ry«n1 Cwfrt y�4a r«,.'. fw it....•« lu ..ter..
<br /> C'rstnm.r's mat.rial or tooko it retain soomnl., in on xiay rnostitut.s a
<br /> "ivtl. ur CustWllel''s ubliyatiuu to pr-operly Lla.ssify its materials.
<br /> Coof.ty-Kl..n r.li.s on Customer's r.pres.ntatinns wnd Customer is
<br /> 1'CfpullD lblC rel' lrlru Pllllrlg SarCly-Kleen or an) pruLess Lhanuas L114L limy
<br /> alter th. thar•ntt«.•istins of tier materials pr•ovid.4 TN THF rVFNT OF
<br /> AN EMERGENCY CALL "Z4 1t@ NUMDER" 1 300 4bS 1160 (Safety Klcen)
<br /> Slgrulture
<br /> CUSTOMER / GENERATOR: John Villierme
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