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os Environmental Serv►-�es <br /> 1515 South River Rd. <br /> CENEF West Sacramento, CA 95691 <br /> (916) 371-5747 RECEI <br /> CAD044003556 J. D <br /> JUN 4 2013 , blN�bd3p <br /> wNO� <br /> ENVIRONMENTAL HEAD.TH SERVICE Q 3DER <br /> v c <br /> ENVIRON( Q�v � <br /> L <br /> DEPARTMENT BILL 4F LADING . ® ' � <br /> DATE -= f - JOB NUMBER �301 <br /> GENERATOR <br /> —_......_..—_.— GENERATOR EPA# C '�`( ` '• <br /> Bit-LING ADDRESS _._. <br /> AMOUNT(IF ANY) <br /> GENERATOR(}CO�, TA�¢CTf } <br /> PHONE . t �" b " '% ! -- CHECK NUMBER <br /> ___.. P.O. NUMBER <br /> JOB SITE ADDRESS NIL M ° V .`, _. 7 . <br /> CASH RECEIVED (amt.) <br /> HALIDES --1� �f <br /> P.P.M. <br /> JOB DESCRIPTION <br /> MATERIALS <br /> NON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE# <br /> NON RCRA HAZARDOUS WASTE. SOLID- LIQUID CODE# 1 S <br /> START TIME 'i � 1 <br /> U.S. DOT DESCRIPTION: END TIME <br /> (USED ANTI-FREEZE)NON RCRA HAZARDOUS WASTE LIQUID CODE# USED OIL FILTERS _ _ DRUMS <br /> MANIFEST O. ._gIa 'las _ NO.OF GALLONS J <br /> DRIVER'S SIGNATURE --� _ TRUCK# _ / <br /> DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES. 1515 SOUTH RIVER RD. WEST SACRAMENTO 95691 CAD 044003556 <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY OTHER WASTE,AND THE TOTAL HALIDES ARE LESS THAN 1000 PRM. <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 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.Ramos 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 /> All used oil collected from the generator listed above will be transported only to a facility pen-itted by the State oT'California to accept used oil. <br /> Terms-net 15 days. <br /> After due date,a finance charge of 1.50% permonth, 18.010%annual rate,•will' e 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,purpgses of enforcement of thin obligation shall be Ygio County. <br /> I doclaro,under penalty of pt�ijury that the foregoing is true and correct, <br /> X <br /> .. r r M , <br /> NA "Lk <br /> GENERATO SIGNATURE <br /> 24: Hour Emergency Response Team: 1-800-456-SPILL , " = <br />