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<br /> aL¢r US/06/IU OY:SS YAW d
<br /> t16)K TSL'am of )vaeph R I1.-lr OS/06/16 O9:SS PAGE 1 Joseph H l ima Jr
<br /> t5G SN•SSL-IR10-01
<br /> Safety-Kleen Systems, Inc. SHIPPING DOCUMENT REFERtNCt NOR-
<br /> ,9 2600 N Central Eapy, Suite 200 /004005
<br /> ,,.. Richardson• TX 75080
<br /> CUSIOMER#/6ENERAIOR: CAS4383 Cal Trans -Main Shop SRV(DAfC: 05/06/16
<br /> CORPORA
<br /> All; 800-669-5)40 1(103 S 0 St
<br /> Va 24 IR EMERGENCY: 800-468-1760 (Safety-Klee.) StnI,ktorl CA 9510,-2476
<br /> 2095451011 PHONE 559-914-4176 CON7'AC1 NAME: Cal Trans - Main 5
<br /> 1VR CUSTIIMERS CAS4383 (.1leans -!fain Stint,
<br /> REFERENCE 5 CkNIKAIOLL 1yS�IVA 1D. CA 981501/Sb 4ENGNAIUN SLASH
<br /> Fa 1603 S 6 St ° SHLV#21911/5/6
<br /> SRVC WEEK: 2016-19 MANlft11#:aND53193LJSKS F(IRFI Co: 1D
<br /> •�• - Stockton CA 95206-14/6 SRVC'DATE: 05/06/16 09:55 INANSYONItH 1 lXR000D81L05 SAFt1Y SO50NSALIDAMBLVDNC
<br /> PHONE 559-924 4176 SALIDA,CA. 95368
<br /> )19 BILL FO CUSTOMERS BILL 10 ADDRESS: 1NSV PHONE: 209-545-1011
<br /> CAS4383 Cal Trans - Main Shop
<br /> 3, 3603 S B St 1RANSPORTER 2
<br /> Stockton
<br /> �'', CA 95206-2476 (t UUIN4 VNUYEN SIIlYM tN4 NAIL. f1ALARU(LASS' AND it))
<br /> PHONE S59-924-4176 US Vol UIS(HLPILON CLN
<br /> all: PURCHASE ORUtR# TAX tXEMPT#
<br /> Fz PRODUCT/SERVICES (USED OIL)ALARDUus WAS Iti. LIQUID
<br /> SERVICE/ TOTAL FEDERAL WASTE CODES NONE
<br /> PkODU(I Q-rV ON 111 PR1Ct TAX CHANGE STATE WASTE CODES 221
<br /> f TOTAL CONT t NNE ll W7/VOL G SKID
<br /> 1 11249
<br /> :01S 66636 USED OIL NUN YREQUAL StNV 07 0.2900 0.00 0.29 CNTY: 160106549343 SL: SULK VOLUME CONIAININ UIY: 345 PROP# 15601/ (A
<br /> SERVICE TERM 10 WEEK
<br /> HALOGEN/IIOX-U-IEC'1 rt1(kESULI PASS: PPM<1000 DESIGNATED FACILITY NAME/ADDRESS:
<br /> SAFETY-KLEEN OF CALIFORNIA. INC.
<br /> e 66b65 ANI1f RLIZE (NUN YktQUAL) 60.000 1.0000 0.00 60.00 6880 SMITH AVE. F
<br /> I WICE fiRM 10 WEEK NEWARK CA 94560
<br /> V-n HALOGEN/CLON-D-ItCY TEST HESULf PASS: PPM<1000 TSD PHONE: 510-795-4400 P
<br /> #(UNIS: 1 ISUF: "I M "'Ill: 11114111111 111(U: US"I'll 11911/51"
<br /> Ft (Nei: 1601065491St Off. 60 WI/VOL 4 PROF#116030 1KDol 611 FACILITY USEPA ID NO CAD96OSS7418
<br /> FACILITY STATE ID NO
<br /> 10154 Ftt, UStU OIL SIUY CHANGE 1.000 G1S.000 0.00 Z15.00
<br /> )19 TERM 10 WEEK.
<br /> If high ri>k >uurae, rep. a .tific, that luaJ>Vea ific PCB 5 S-il Icon
<br /> IOIAL StHVI(t/VHODUCIS 416.2900 0.00 275.29 to,tiny have bezel LwnPleted pr iur lu plmy,nny this load.
<br /> IOrAL CHARGE 275.29
<br /> �1 CREDI R 0.00 GENERATOR STATUS
<br /> SQG/LQG:Vehicle
<br /> PE TOTAL DUE 215.19
<br /> F -. Cu.turua'.rel trio Ll..l (i) Ice eLove um,eJ mater ial,are Prupr rl)' r
<br /> - nnd;l iur,
<br /> _ .1« .ific,(, ynr FavrA, arkeA«nJ 1aL<lrrl, u'I a in Vr'uyrr
<br /> UNPAID BALANCE THIS RECENT 275.49 furs!rwn,y,.,rwl .......
<br /> n. urJ;ny to lb; ayll is able requl nt iu ooze tha
<br /> pry«r rwrnr u!Tr w„+Vurtwt u (ii) iu lcr•i 1 Llrarrye I,.+ta eua e,a
<br /> ill,.r else .1,.rw.t.ri+l ir�> n/ the wa+l a/nater ial ar i,. ll,e1 Pr
<br /> " - wf... Cu>w, Va slur a1u h.rge
<br /> uln. [I,r r .u,lt uu,l i[iu >C`) el f ala <uriJ Ile
<br /> .l euro!ril i s Vr'..r l,leJ >cpurat ly�tu Cual iii , (V)
<br /> wnyr'•k «urr.u,<nt ,nyneA 4y tCustw anJ SK, nd (2) inauryvra teJ
<br /> I("LL" risk a rev. eel it ira ILat load>yc ifir VCR&5il i.to he i by refer e. 11n1r1. u;heK i inJ iaatyd in the ea`ureol
<br /> te>t iny have Lccnacunyrictrd Vr iur to pang,iny Ili i,a luaA. re r vv,l -.ecli, ,r SK i ••rllru <el tueClr•Ue C toner s uune1 fur
<br /> th i.Ilr«„>ar1i. If Cw lomu'r(•i�l. to make paywe it v;hen Aue, I
<br /> np equ.I 1. the I<„er of Ci} 1.1%Ve ,untlr (18%Vr mr uuJ U.-
<br /> GENERATOR STATUS (ti i) the roarra.n tun.ant a1luv.eA 4, I." v:il!1 Le aJJ6J tUr al lttunpa iJ
<br /> SQG/L(G: Vehicle mwn,n 1,UW>InnJiuyt Castrnr art it111-1 the iud iv iJual argn iuy
<br /> this Service Aaknowltdytne„tri, July -0 101 izl le lig" and"I'd
<br /> eualwuer ao't ifir, ILaI (i) lLc aLUvc-ret rd mel tr talo are prvyr+'ly Cu,Iwimr. Custw�mr•aAnuv,irJyr, Ilett it i resyun,iLle fur vain t.;nino
<br /> ria»ifir!, vacLnyr.l,
<br /> L,.1 UJ InbI,1 rd. nnJ a i proper a nd it ion it>(.ener.l nr Sl•tu,urJ nota in u,y a. CPA>ID nwnLer if require!Ly
<br /> fur trona tat iun ata ur.I in to the 7 ia.aLle re tlat io ul'utl.e +pVl ia•Lit law 'The ""ll
<br /> low ing yrU v u ayyl icaLle to I..
<br /> nye, rya , i u
<br /> Onv.,Uim„1 f Tra.,yu.1.1 iu (i i) nu r Err ial ahanyc haa11uaau ray Safety Nir<• s yr is cl tante .nJ V•inttr9un cl toner , rviCea: Cuatw ,
<br /> e;the in it'.ah.....A—nal iaa of !lir wast eiinetcr ial ur in thcr Pru .ger > th.ttr it c,ill n.I inlruduae+ny zuL,tnnnr 'n tuctl�e auvenl
<br /> Per 'at iny lhr wase,/nwterial, and (iii) Thr eb.v rcfc U rd wyuvuu,rice in0>olot;"n, ,,I.Jiny wnthuut liiiitat iu Until.....lU
<br /> Gcncr•tm'Status ;>au rcat. Cua twucr ay rel, to Vey the aLua<Lheryra w.,tc m'ha<arJuo,n+z t< aumlit.ent, a ,,pt to the totem such
<br /> and to Lc Lomrd Ly tbetfm•nu mol cunt itimu <1) act forth in cap the intrad«ti.,n i iu<iAeulal to Thr na r,oal use of the oath iuc. Cu>lmimr
<br /> Gcncrnl ie row and CmrJ it iun, Prua'iJrd xpI'. tcly to Cw tunmr or (L) roc tLcr •yrno'ILat it will out alt.n Par t,1'ya int ooze, tLat Lave Leen
<br /> m„SN eyrernrcul signed by Cual outer and SK, and (2) inaorporatId untmuinateA With or vthtrv.ion in traduce yul ychlur inate,l LivLenyla
<br /> herr in Ly refci cna e. Uulc„ ulLerw tae inJ iLateJ in the Iwnt >), Ircrb is W.II. V<a[ic iJes, Jioc ins or Iia teJ he<arJuus was to
<br /> ria int. the aul vent ur aNucuu, clean i.y solution. 5afetY-Kneen Ira, tLe
<br /> veJ seat ion, SK i>out hue i<ed to ahargr.Cu>tuna•r', a aunt fur 't mJ is Vertu itteJ to as try[, ,tore, enJ/or reClai, [Ire>Vrnl
<br /> lh la ttrml,aCt ion. If Cuatumtr fni l> to melt yaMnrnt when due, a'pa" u aul vents anJ [> teA L
<br /> Iw ut eyual to the leaser 1.5%per month (18%Vrr an an) m, Pa t,,. ,Ler ,ulv<uC Va i,.t th Inure>, V.in non.ra r
<br /> m u
<br /> enJ,till
<br /> (i i3 the:::at i-u::.a:::_rt a?L.::A b; ?a;., i:"l be.added:_ at lt::y::;;J > ;nF f idyes, Puv.dce ht Le, n
<br /> <u>tw„<r. r Icon it ter Ln,tr
<br /> unto uut,tan'iny. Coal wuer ar r'l ific, that t11t indiv iJual ccs rJur .unl.is inq p<'r.lurur thyl<nt, t•<l cul<wu r,y •
<br /> Lh la Service ACknuwled t is Jul autLor n<eJ to ,19enny lr iflurolr naLlurunthmcc Jry al<a„iny,.I,cnt,. eu,luumr au�'ee> Ural rl
<br /> ye,nrn y aiyn.red Lind is rc,pun>iLlt fur V['uVcrly Claa ify iny it,vast" ,trtmn,a,Uard Oil
<br /> Curtwcer. Cuatwuer ncknavleAgc, lhnt it is re>puna iLlc fur ia,nta nnnug or Nunha<arJuu,Waal in nlcur'Janne v.ith the Vruv n>iun of 40 CFR �I
<br /> its Generat.r Status and ubt.ininy are EPA ID nauber if r.q.ir rd b Kr e
<br /> > 262.11 and appli,.ble state law,. Cu>tw, pyre, that it will riot
<br /> applicablt law. Th,, ov
<br /> followiny provision i,applicable to
<br /> Safety-Klee s par I.C1 ra anJ paint Pur cieener> Cu,tmu<r iulruduae any r - uu form iny ,ub,tanCe into the SK Prvyerly,
<br /> agars that tit,ill ..wt int r..•b..r « .,d.>rrn.r ha zee thresulat.n-o ial uJ iny, w tl uutcl imilel ion, mry hn<arJuua was to ur hn<nrduu>vale
<br /> evu<uus altar iny>ululimi, uludiuy,.e ith..t 1 L"itat;an any La<m duo, a ut itumlt.(i.t., Vul;cLl ur tushed L.u, 1, ("PCei'), her•L is idea
<br /> nate or h.urduu+waste c n,titueot, ellcpt w lh<e.lcnt x¢L Vcat is ulc,, Jiva iu'listtII ha<arduun ,.,tc,) a cq.l [u the e,ttnt
<br /> w aucL nutIoJac1.1. i naidmrtal to thenu
<br /> ial oat uF the SK Pruyerty.
<br /> introduel ion i, iaa idtntal to the rwrmel use uF the mash ire. Cuw�llI In the<cut of lLe�intreAult ion f u - unfurw inq La<arduu> III
<br /> furlLcr.yreea that it will nut a1tm,part,JVaini Pun, that have 6_:,
<br /> unlauinat<u v.itL ur others.i>< introduce Vaal rCbl ar inaatd L;r,htu>l, .nate, Cualw ger agrt, that it wall Le re,von,iLle fur all coals and
<br /> h.Ibicidc+, Y<,t iaidc,, dio>in,ur lis(td hacarduu,wmtc u:J Int iuu e.apc •elate! to a nr i>inq from Ice pr'upe IaUenienl
<br /> int. the solvent or eq.<o 0l 11iny,alar iur,. Safety-Kkoi ha, the and Jiavo>.l of�theanu l-cunfor�n inU v,e,te, iucludinu the L.I I.,
<br /> aap.l ity enJ >Permitted Lu accept, ,tune, cud/U, ,<aleiw the,Pen[ <qu ilnnen(de.Utmuivaltiuu and tuba Iju,UL disposal. Final vuiLinO
<br /> °arra washer,o77". Paint tL inner>, solvent,and Ve int,yeucreteA Lp :ill Lc be>ed mr the adze.! scrviaes pro idrd, vb idr may include
<br /> u>tw, r Jry alta iny filter Cart,idgea, yuwAm•, anJ still addiLi.U.1 11-Y- fur off 111 cifiaatiunvwaa to and a 'ahargca. Final
<br /> residues CUnta ininy Pe"I'uruetlglene, Velrulean nephlha, iuvu ice m ant clay Le. e than tht m gut lite!Uruthe pr intrd
<br /> Lriflurutrieh7uruelLanc Jry Clean irru,ul vents. Cu. I't'a9re a that it eillt. If any legal action cJ Lacau,e of n a11.vd
<br /> is resporaiLlt for prol,c rly cla>,ifyiny it, ,Ere saUsrd Oil disyule, LrenaL, Je Fault u rcyr enlat iun, the Cu>tw also
<br /> r Nonhe<nrduua W'a,le in ac orJvrce witL LLev Vruv is ionmof 40 CFR ayrc.a tLa[ the Preva it ingt party .ill Le ctit7eA [o rte er
<br /> 262.11 and appI icaLle I, 1 aws. Cuaiw mr a9re a tLnt it wit 11 out m41c auu�uy'a fees and costs ......
<br /> toted v i lLeov
<br /> introJuce any n un(o Twiny auLslanae ioto the SN Property, - uufur ting cuntm tat tune ;n 1. Safely-Klee safe ilu r to
<br /> i ncl.J in I. v:it,"... Iimit.tion, any La<m'J...rate u'La<arJom waste Cualw mlm ial u take vr.ta ,mnylc inti my C Tat iluteaea
<br /> constituent,(i.r., pulpa hjm nnated biphenyls ("PCB,"), herb is ides, euf Cu,lm uLl igal iuu to tpruperly Cla»ifY Ila umtrr talo.
<br /> Ipe tis id.,, Jivain,, ur IIatI, ha<ard...zea.I—) a ..It to the extent Safely Klcrn rel Ica>un Cust woe r'a rcprc,ental iuli>and Cu,twucr iz i,
<br /> u(h inlruducl iun i nC iJental lu [hc n iml u Uf the SK F'ruperty. eayu aiill fuI infui,inq Safety-Kl ern Uf art yruce>a allanue, that may
<br /> '[n Use a ort of C"i,; truduct iun of sus bun - on forn�ing La<ardu. alteruthe aLm'aCI isliu of it nate i.l.provided. IN THE EVENT of
<br /> •nate, Cu,t umer agrees t6al it will be re,yun>ible fur.11 _.I.and AN EMERGENCY CALL `"24-HH NUMBERG° 1-800-468-1160 (Safe t y-K1 ren)
<br /> aJ i.l iun c P.0 a rel.tId lu o iny frau lLe PI.Per n naytmerd I Lave eataLl iahrJ a Pru 11"1 lu rcduar L1, vol wire ur Numit ity anA
<br /> and cl i,pus.l of the.......fm'ru iuy waste, i rcluJ iny the w,i of lu. it, of i6e ha<arJuu>was tc lu tht Jcgrm w Le ecoumuically
<br /> epu it.nrnt dccunlmnlnaat iun ar,J,uLacyuent J;spu>•1. Final iuva ie inU practiceLle. f}:
<br /> will Le based on the ctual strvices provided, whish nay include -
<br /> add it;on•1 chnyes for off then i(icat iun waste anJ a rcLar'gt,. Final 4]���-�'-_•
<br /> invoice m�wunt nay
<br /> to
<br /> - than the m wont li>ted mrutLe yr inled
<br /> receipt. If any 1.0.1 Lti.. i>Cwuie cad because of an all eget
<br /> di,pute, LI default urmisrepresentat iur,, the Curtomm•III—
<br /> agrees that the yrevail9nyparty will Le err titled to recover G7
<br /> ,ta,,.uaLle -Z
<br /> fees an,a,.,il.,,,zea tate!..iU, tLc c, _77
<br /> - or,funu iuy Coutmi not iun event. Safety-Kleen'a Fn it ore to__U
<br /> Cuatarwr'a 'ter nal or take a rets iu s"I r, inn way aon,l;luta,• _
<br /> of Cu,tw��e r'z oLl iUat iuu lu yroperly classify its materials. ---- --- Sir titlrn
<br /> Se(ety-Klee rel its un Custw�rr's reVre,eutal ions and Cu,twa-
<br /> espuna rLle rfor inform i„Y Safety-Kneen ur any protea,change:, beat uw,
<br /> alter' the aharac Lerixt its of the m.ter nal,Provided. IN THF.]VENT OF
<br /> AN EMERGENCY CALL G 4-HH NUMUER_1 800-468-1760 (Safety-Klecn) CUSIOMER/GENERA(DR: Cal Lyon, -Main Sha°mark 1--Yl'I have tstabl i,hed a V"""to reduce the,1_u•quant and
<br /> loaicity of the h.< Juus este to IbI,Jeyree to Lrt ecunaine.ally II,
<br /> practicable.
<br /> � SIUItnIlYO ----
<br /> SI 'lu
<br /> 'IRANSPOR'fFR: Joseph R Lima Jr
<br /> CUSTOMER/GENERATOR: Cal Trans -Main Shop nark hoyle
<br /> LAST PAGE
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