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09/27/2014 TUE 16: 14 FAX 1®016/024 <br /> CSG S[(^SSL-a0X-23 Raymond Gomez 09/22/16 11:02 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REF6R9NC2 NAR. <br /> CUSTOMERN/GENERATOR: B021038 Soba Lube 6 smog 11471385-1602976642 <br /> 1403 Country Club Blvd <br /> SLockton CA 95204-4910 SRVC DATEt 09/22/16 <br /> PHONE 209943-3633 CONTACT NAMEt Bobe Luba 6 Smog <br /> GENERATOR USEPA I0. CAD9R2357717 GENERATOR STATE 00006 <br /> MANIFF.ST4; 0055239820.5 FORM CD: IP SHIPY 220284951 <br /> TRANSPORTER I TXROOOO 1205 SAFSTY-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, LIQUID <br /> (AQUEOUS PARTS WASHER SOLUTION) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 134 <br /> TOTAL CONT 1 TYPE oM WT/VOT. G SKDOT 14941 <br /> CNTA: 16091311355.1 67: 30 GAL/114 L CONTAINF.RF QTY: 20 PROsO 156023 CA CAT CODE:G <br /> UESIGNATEU FACILITY 4E/AwKEs8: <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 6000 88TH STREET <br /> SACRAMENTO CA 95828 <br /> TSO PHONE: 916-306-4913 <br /> rACILTTY USEPA ID NO CAQOD0004517 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 0-220 iba/mont.h <br /> Cur,t.nmar. rr.rtifier. L at (i) Lhe above-named materials are properly <br /> classified, packaged, marked and labeled, and are in proper condition <br /> for transportation a cording to the applicable regulations of the <br /> Department of Transp station Ili) no material ghonge has occurred <br /> either in the charac oristics of the waste/material or in the process <br /> generating the waste material, and (Ili) the above refereneed <br /> Generator Statue is orroct. CU9tomor agrec3 to pay Lhe above chdryea <br /> and to be bound by t e terms and conditions (1) set forth in (a) Lhn <br /> General Terme and Co ditions provided separately to Customer or (b) <br /> any SK agreement sighed by Customer and SK, and (2) Incorporated <br /> herein by reference. Unleda oLkerwide 1ndicaLed in the payment <br /> rrrr.lvrd xrr.tion, SK ix nuthurizrd t.0 0virge r1intumer's account for <br /> this transaction. If Customer fn[lx tp make paymrnL when due, an <br /> amount equal to the lesser of li) 1.58 per month (10% per armwn) 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 Acktlowl dgement is duly authorized to sign and bind <br /> Cuatomer, Cuatomer a knowledges that it is responsible for maintaining <br /> it. General;or Status and obtaining an CPA ID number if required by <br /> applicable law. The lQ11owing provision is applicable to <br /> 6afety-Kleen's parts cleaner and paint gun cleaner serviceat Customer <br /> agrees that it will tot introduce any oubstancc Into Lhe solvent or <br /> aqueous cleaning sol tion, including without lim.itaLion any 1d2arduua <br /> waste or hazardous w4 ate constituent, except to the cxtnnt; r.urh <br /> introduction is incl(ental to the normal use of the machine. Customnr <br /> further agrees that t will not clean parte/paint guns that have been <br /> conLaminal..ed with ur ulherwise Introduce polychlorinated biphenyls <br /> (pr.B'a), hr.Yb).iv.idr.e, pmil.iridea, dioxins or listed hazardous waste <br /> into the solvent or gUnnN, rin;ening rnlution. SafeLy-Kleen has the <br /> capacity and is perm tted to accept, store, and/or reclaim the spent <br /> parts washer solvent paint thinners, solvents and paints generated by <br /> customeri or dry cleaning filter cartridges, powder, and still <br /> residues containing imrchloroethylone, petrolcvm naphtha, or <br />