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Ramos Envoronrl enta8 Servooes <br /> 1515 South River Rd . <br /> West Sacramento , CA 95691 <br /> (916) 371 -5747 <br /> CAD044003556 <br /> SERV9CE <br /> SERVO CG (ORDER ® PI ® ER MO <br /> L OF LADEN <br /> In <br /> In <br /> In seen <br /> DATE ` JOB NUMBER <br /> ee <br /> GENERATOR GENERATOR EPA <br /> BILLING ADDRESS <br /> AMOUNT (IF ANY) <br /> GENERATOR CONTACT sCHECK NUMBER <br /> PHONE InP. O . NUMBER <br /> JOB SITE ADDRESS ' CASH RECEIVED (amt . ) <br /> rIs <br /> In I <br /> rn fee I _ IIIIffell HALIDES P. P. M . <br /> JOB DESCRIPTIONIs Z,j if CIL I If <br /> MATERIALS <br /> Is I es START TIME <br /> Isen If Is I <br /> F] NON RCRA HAZARDOUS WASTE LIQUID , (USED OIL) CODE <br /> ARRIVE TIME <br /> NON RCRA HAZARDOUS WASTE . SOLID - LIQUID CODE # LEAVE JOB <br /> U . S . DOT DESCRIPTION : STOP TIME <br /> (USED ANTI - FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # USED OIL FILTERS DRUMS <br /> 11 Is Is <br /> MANIFEST NO . If ' NO . OF GALLONS <br /> If I <br /> DRIVER ' S SIGNATUREIs In <br /> 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 P. P. M . <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 permitted by the State of California to accept used oil . <br /> Terms - net 015 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 andcorrect. <br /> X <br /> GENERATOR SIGNATURE <br /> If <br /> Jennee 3 ' C f S + In In In " Ifni IsIse <br />