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ad 9I � 19A tlVr ® Ql 8 ! ®' � ltlt is Ickes covering coppery ofbmllhas and is not thy oi9na dnl copy { ria a here reds seely for filing or record Shipper's No . Carrier RAMOS ENVIRONMENTAL SERVICES SCAC Carrier's No . RECEIVED, subject to individually determined rates or contracts that have been agreed upon in writing belween the carrier and shipper, if applicable, otherwise to the rates, classifications and rules that have been established by the carrier and are available to the shipper, on request; and all applicable state and federal regulations; at , date from t r t5a c r 7 the Property described below, in apparent good order, except as noted (contents and annus lion of contents of packages unknown), marked, consigned, and destined as indicated below, which said company (the word company being understood throughout this contract as meaning any person or comoralion in possession of the property under the contract) agrees to carry to delivery at said destination, if on its outer or otherwise to deliver to another carrier on the route to said destfnahon. It is mutually agreed as to each carrier of all or any of said Property over all or any portion of said route to destination, and as to each party at any lime interested in all or any of said Property that every Service to be performed hereunder shall be subject to all the conditions not prohibited by late, whether printed or written, herein contained, Including the conditions on the back hereof, which are hereby agreed to by the shipper and accepted for himself and his assigns. TO : FROM : Consignee SII; SF�'t Fig TRt3 ? 9S Shipper s 1L ) Y' YI < lt_ '^` i ' Street 401 WEST C§°" ANISIEL DRIVE Street Destination GENICIAre CA Zip 10 Origin — Route CAL 301639 Delivering Carrier Vehicle Number U .S . DOT Hazmat Reg . No. � . N/A N/A DRAINED USED OIL FILTERS N/A N/A S P N/A SIO # _ER_C9NTRAOT911fAMOS ENVIRONMENTAL SERVICES Subject to eoul 7 of conditions. It this COD FEE : Remit COD to: shipment e e delivered m the Consignee COD AMT: without recourse on the consignor, the ❑ Address: r shall sign the faua,ving statement: Prepaid consignor carrier shag not make delivery of this City:Cit State : Zip : shipment wlth°°t payment of Ire ight and an $ Collect ❑ $ other tactful charges. NOTE: Where the rate is dependent on value, scuppers a required to slate specifically in writing TOTAL CHARGES: FREIGHT CHARGES: the agreed or declared value of the property. The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding $ Per (aggregate of c°matgna) ❑ Prepaid El Collect NOTE: Liability Limitation for loss or damage in this shipment may be applicable. See 49 U.S.C. 14796c) 1 A and B). 6V SHIPPER BY CARRIER This is to certify that the above-named materials are properly classified, described, packaged, marketl _ s _ • ' and labeled, and are in proper condition for transportation according to the applicable regulations of OflIVEfl'S the Department of Transportation. Per _ , SIGNATURE: - SHIPPER: p` e cl v r cARRrE OS EN )fiONMENI7"AL SERVICES PER: r`-� DATE: !J ' e Irk Z C) PER �'"�G. DATE: bj " L - EMER07ENCY RESPONSE NAME OR CONTRACT NUMBER TELEPHONE NUMBER: (916) 371747 OR OTHER UNIQUE IDENTIFIER : 969 (Rev. 3/17) a