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UD/G(/6Ulu TUB it, 1G k'Ax IQ919/9Za <br /> CSG SK-88L-80X-24 Raymond Gomez 06/2'i/16 12:23 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR. <br /> CUSTOMER#/GENERATOR: 1021038 Bobs Lube t; smog 70698636 <br /> 1403 Country Club Blvd <br /> Stockton CA 95204-4910 SRVC DATE: 06/27/16 <br /> PHONE 209-943-3633 CONTACT NAMEt Bobs Lube k Smog <br /> GENERATOR USEPA 10. C D982357717 GENERATOR STATE D0006 <br /> MANIFESTO! 005328640ses FORM CD: 1D SHIP# 219569896 <br /> TRANSPORTER I TXAODDO 1205 SAFETY-KLEEN SYSTEMS, INC. <br /> 9050 SRI,T hA RI,Vn <br /> SALIUA,CA, 95368 <br /> TNSP PRUNEt 209-545.1011 <br /> T'RANSPORT'ER 2 <br /> US DOT DESCRIPTION (I CLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) <br /> NON-RCRA HAZARDOUS WA3TS, LIQUID <br /> (AQUEOUS eART5 WASHER SOLUTION) <br /> FEDERAL WASTE CODES N NE <br /> STATE WASTE CODES 134 <br /> TOTAL CONT 1 PYPE 014 WT/V0L G SXDOT 14941 <br /> CNT#t 160624507078 2; 30 GAL/114 L CONTAINERS QTYi 20 PROF# 156023 CA CAT CODE!G <br /> DESIGNATED FACILITY N 4E/ADDRESSt <br /> SAFETY-KLEEN SYSTEMS INC. <br /> 6000 88TH STREET <br /> SACRAMENTD CA 95828 <br /> TSD PHONE: 916-386-4913 <br /> FACILITY USEPA ID NO A0000064517 <br /> FACILITY STATE TP NO <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Customer certifies thBt (i) the above-named materials are properly <br /> classified, paekaged, marked and labeled, and are in proper condition <br /> for LrannporLaLlon ac•Urdltny to L'hc applleable reyulat.iona of the <br /> Dnpnrl:mr.nt: of: TrannpnrL.,flAnn (it) no maheriml ahnngr hart arrurrrd <br /> either in tho rharaot.•, ri.%tfri Of t•he waste/mot•ori.:fi. or an thn prormma <br /> generating the waste/ ateri.al, and (iii.) the above referenced <br /> Generator Status is c rrect. 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 Terms and conditions provided separately to Customer or (b) <br /> any SK agreement signed by Customer and SK, and (2) incorporated <br /> herein by refer*nte. Unless Oth*rWiee Indicated in the payment <br /> received section, SK ).s authorized to charge Customer',% account for <br /> this transaction. If Customer fails to make payment when dve, on <br /> amount equal to the lesser of (1) 1,51 per month (181 per annum) or <br /> (it) 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 /> ll.n Generator SF.at.ua aftU ubLaininy an EPA ID number if required by <br /> applirnblr. 1nw. The Cullowing provlmion In applicable Lu <br /> Safnty-Klnnn'm pirF.s ragonrr and paint, gun rlenner nervir.rm: CUaLomer <br /> agrees that it will rot 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 inci ental to the normal use of the machine. Customer <br /> Iurther agrees that it will not clean parts/paint guns that have been <br /> contaminated with or otherwise introduce polychlorinated biphenyls <br /> (PCB's), herbicides, pesticides, dioxins or listed hazardous waste <br /> into the aolveht or vqQvovz clmoniny 4oluLion. Safety-Kleen has the <br /> capacity and is pore tted to accept, sto=r, and/01, reclalm the spent <br /> part* wa•7hor .7olvonti paint thtnnrr.n, oo.lvnnLn and paints generated by <br /> cuatomori or dry cls ninq filter r..arr,r.idgos, powdor, and stl..0 <br /> residues containing Ferchloroethylene, petroleum naphtha, or. <br />