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0 <br />1 tp <br />-. SfOnohre <br />CUSTOMER'/ GENERATOR: IOhq field-. <br />1 _ <br />Sipnatrlre <br />TRANSPORTER, lnseph R Lima Jr <br />CSG Sa-SSL-Uhtti-01 3OSeph R Lima ]r 07/18/18 06;33 PAGE 2 <br />SHIPPING DOCUMENT <br />i REFERENCE Ni3R. - <br />( CU5TOMERA/GENERATOR: SN'10083 Swift Transportation Co 77445050-1803640463 <br />901 Darcy Pkwy <br />Lathrop CA 95330-8764 <br />a PRONE ZOO -ASS -7027 <br />U GENERATOR US£PA ID. CARO00053287 CENCRATOR STATE 9060Q1999g <br />r MANIFEST$; 005946Sa8SNS FORM CO., ID SHIPS 22S980101 <br />t TRANSP09M i TX11Oo00a12O5 SAFETY-kl.EEN sYslmms, 1Nc. <br />° 5050 SALIDA BLVD c . <br />( SALYDA,CA. 9,368 <br />a TNSP PRONE: 200-545-1011 <br />t TRANSPORTER 2 <br />14 C <br />i US DOT DESCRIPTION (INCLUDING PROPER -SHIPPING NAME. HAZARD CLASS, AND TD) <br />al <br />S, NON RCRA HAZARDOUS ifAS'IE,LSQUXD <br />a! ETHYLENE GLYCOL SOLUTION (LESS THAN 5050 <br />At FEDERAL WASTE CODES NONE <br />W1 STATE WASTE CODES 133 <br />it TOTAL CONT 1 TYPE TT Wr/VOL G SKDOT 651 <br />f@ CRT#' 180715555104 SZ: DULk VOLUMI£ CONTAINER QTY; 65 PROF# 156030 CA <br />u <br />DESICNATEO FACILITY NAMr/ADORESS; ' <br />in SAFETY-KLEEN OF CALTFORNIA <br />CE 6880 SMITE{ AVE, <br />pa NEWARK CA 94560 <br />TSO PHONE: 510-795-4400 <br />FACILITY USEPA ID No CAU980887413 <br />FACILITY STATE TO No <br />If high risk source, rep. certifies that load specific PCR & Silicon <br />testing !rave been completed prior to pumping this load. <br />CSI GENERATOR STATUS <br />*e CESQG; vehicle <br />X Customer certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />for transportation according to tilt applicable regulations of the. <br />Department of Transportation (ii) ao material change bas occurred <br />tither in the characteristics of the waste/material or in tilt process <br />generating the waste/material, and (iii) the above referented <br />Geatrator Status is correct. Customer agrees to pay the above charges <br />and to be bound by the terms and conditions (1) stt forth iu (a) tilt <br />General Terms and Conditions provided separately to Customer or (b) <br />any SN agreement signed by Customer and SK, and (2) incorporated <br />heroin by reference. Unless otherwise indicated in the paNuent <br />received section, Sk is authorized to rharge Customer's account for <br />this transaction. If Customer fails to (Flake payment when due., an <br />amount equal to the lessor of (i) 1.S% per month CIS% per annum) or <br />(ii) the maximum amount allowed by law, will be added to all unpaid <br />mnauuts.autstaiding. Customer.certifies-that.tht individual signing <br />tri'fs Service Aek'ncwled¢tindnti'is dilly author itd'tosign and bind <br />Customer. Customer acknowledges that it is res passible for maintaining <br />it% Generator Status and obtaining an EPA Io number if required by <br />aPplieable lar:. The following provision is applicable to <br />Safety-klten's parts claaaer and paint gun cleaner services: Customer <br />agrees that it will not introduce any substance into the solvtnt or <br />aqueous eleaaing solution, including without limitation any hazardous <br />waste or hazardous waste coastit{rent, except to the extent such <br />Utreduction is incidental to the normal use of the machine- Customer <br />further agrees that it will not clean parts/paint guns that have been <br />contaminated with or otherwlse introduce polychlorinated hipheayls <br />(PCB's), herbicides, oesticides, dioxins or listrd hazardous waste <br />'f <br />