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F%nos Environmental Serves <br /> 1515 South River Rd. <br /> West Sacramento, CA 95691 <br /> (916) 371-5747 INVOICE # <br /> CAD044003556 <br /> SERVICE <br /> SERVICE ORDER ORDER NO. 58559 <br /> DATE t' JOB NUMBER <br /> TG <br /> GENERATOR ^fir r� ��-�" [.`•�^ <br /> GENERATOR '°`'-'' "` �' ` GENERATOR EPA# �itl <br /> BILLING ADDRESS <br /> AMOUNT(IF ANY) <br /> GENERATOR CONTACT UE"'TZ CHECK NUMBER <br /> PHONE ,0^? 943-03) ; P.O. NUMBER <br /> 555 '.4= T `? iV CTUp T <br /> JOB SITE ADDRESS CASH RECEIVED (amt.) <br /> '+ HALIDES P.P.M. <br /> JOB DESCRIPTION._ <br /> z� -� ,til�:� 4•'-t c �.. - �., �"' � � ` �:i . <br /> MATERIALS <br /> COMBUSTIBLE LIQUID, N.O.S., NA1993, III, (USED OIL) CODE# <br /> 11 10 <br /> n NON RCRA HAZARDOUS WASTE. SOLID-LIQUID CODE# START TIME <br /> U.S. DOT DESCRIPTION: END TIME <br /> `(USED ANTI-FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE# USED OIL FILTERS [?BUMS <br /> MANIFEST NO. ` t r ^ I i r( 4 NO.OF GALLONS r C�'F <br /> t. <br /> DRIVER'S SIGNATURE ` TRUCK# �~ <br /> DESIGNATED TSDF: RAMOS ENVIR NMENTAL SERVICES. 1515 SOUTH RIVER RD.WEST SACRAMENTO 95691 CAD 044003556 <br /> I HEREBY CERTIFY THAT I HAVE N�T 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 amed articles are properly classified, described, packaged, marked and are in proper condition for <br /> transportation, according to the applicable regulations of the Department of Transportation. <br /> Generator's Certification: I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practicable. Ramo$agrees with the generator to send all their hazardous waste to an authorized hazardous waste treatment facility <br /> via Ramos'standardized permitted storage facility. <br /> Terms-net 15 days. <br /> After due date,a finance charge of 1.50%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 collection of this obligation.Venue for purposes of enforcement of this obligation shall be Yolo County. <br /> I declare,under penalty of perjury that the foregoing is true and correct. <br /> •1} GENERATOR SIGNATURE <br /> 24 Hour Emergency Response Team: 1-800-456-SPILL <br />