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:r <br /> * , <br /> a� <br /> ar '•' �5G <br /> i <br /> Ao ' 'r <br /> • • <br /> • .y �t <br /> a <br /> • • ,f rT . <br /> a <br /> • • <br /> ��--� ------------------------------- ---------------- <br /> CSG SK-SSL-*IMO-01 Joseph R Lima Jr 09/30/1910:13 PAGE 2 <br /> CST:SK-SSL-BOX-23 Reytnond Gott— 08/21/17 14:17 PAGE 2 <br /> SHIPPING DOCUMENT <br /> SHIPPING DOCUMENT IN THE EVENT OF AN EMERGENCY CALL-24-Hr-Number— 1-800-468-1750(Safety-KTeen) <br /> REFERENCE NOR. REFERENCE NBR. <br /> 74602156 CUSTOMER*/GENERATOR: A132435 Auto zone 0 3779 81080926-1904804769 <br /> CUS70MER*/GENERATOR: AU:12935 1111 Man*377!i 3512 Manthey Rd <br /> 3512 Man ley Rd <br /> Stockton CA 95206-5300 <br /> Stockton CA 9!i 206-5300 PHONE 209-982-4127 <br /> PHONE 209-982-1127 CONTACT NAME: Autozone 0 3779 <br /> GENERATOR USEPA ID. CALO00369287 GENERATOR S"LATE GENERATOR USEPA ID. CAL.000369287 GENERATOR STATE <br /> MANIFEST*: 006100479sks FORM CD: 1D SHIP*223248607 MANIFEST*: 007181789SKS FORM CD: 1D SHIP*22%22995 <br /> TRANSPORTER 1 1XR00008120s SAFETY-NLEEN SYSTEMS, INC. TRANSPORTER I TXR000081205 Safety Klee. <br /> S050 SALIDA BLVD SOSO SALIDA BLVD <br /> SALIDA,CA. 95368 SALIDA,CA. 95368 <br /> TNSP PHONE: 209-545-1011 TNSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 TRANSPORTER 2 <br /> US U01 UtSLRIPIION (1NLLUUING PHOPLK SHIPPING NAME, HALARU LLASS, ANU It)) LIS DOT DESCRIPTION <br /> (IN(:LUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) <br /> NON-RCRA HAZARDOUS WASTE, SOLID NON-RCRA HAZARDOUS WASTE, LIQUID <br /> OIRAINED/UNDRAINED USED OIL FILTERS) O1SED OIL) <br /> FEDERAL WASTE CODES NOME FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES STATE WASTE CODES <br /> TOTAL CONT 1 TYPE DM WI/VOL P SNOOT 7872676 TOTAL CONT 1 TYPE TT WT/VOL G SKDOT 11249 <br /> CNT*: 1707ZISS5498 SZ: SS GAL/205 L CONTAINERS QIY: 200 PROF*156033 C CNT*: 190907657960 SZ: BULK VOLUME CONTAINER QTY: 170 PROF*156017 CA <br /> DESIGNATED FACILITY NAME/ADDRESS: DESZOV47 Q FACILITY W E/ADDRESS: <br /> THERMO FLUIDS INC SAFETY-KLEEN OF CALIFORNIA <br /> 12573 5E CARPENTER DR 6880 SMITH AVE. <br /> CILACKAMAS OR 9 7015-8 988 NEWARK CA 94560 <br /> TSD PHONE: 503-788-461ti PSD PHONE: 510-795-4400 <br /> FACILITY USEPA ID NO ORQOOOO25197 FACILITY USEPA ID NO CA0980887418 <br /> FACILITY STATE ID NO FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> GENERATOR STATUS <br /> CESQG: Vehicle <br /> 0-220 lbs/month c <br /> Customer certifies that (i) the above-na edmaterials are Properly <br /> claissified, packayeJ, wnrkeJ-d labeled, anJ are in proper condition <br /> for transportation according to the aPPlicable regulations of the <br /> Department of Transportation (ii) no material change has occurred <br /> either in the characteristics of the waste/nmterial or in the prose» <br /> generating the wastepnaterial, and (iii) the above referenced <br /> Ge �qe r----7- <br /> nerator Status 7s correct. Customer agrees to Pay 1111 above -harges <br /> and to be bowed by the terms and conditions (l) se[ forth in (a) the ` <br /> General Terms and Conditions Provided sepm,ttely to Customer or b <br /> any SK agreement signed by Customer and SK, and O SlOnature <br /> C2) the rporatt <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section, SK is authorized to charge Customer's account fur' CUSTOMER/GENERATIIR: mil ldread <br /> th ir. transaction. If Customer fails to melee payment W <br /> nount equal to the lesser of (S) 1.516 Per--nth.(la� \ <br /> (ii) the maximum anowst allowed by law, will Ube dd;- 07/06/2 <br /> ,• 11 , . <br /> anounts uutstanJ7ny. Customer certifies that the <br /> chi6 <br /> s Service Acknowledgement is July authorized tots W B \ \ <br /> Cos: r. Cut, <br /> acknowledges that it it, respmisib <br /> 1-1 <br /> its Generator Status and obtaining an EPA ID qunUber Q — <br />