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Ramos Environmental Services <br /> 1515 South River Rd . <br /> ' West Sacramento , CA 95691 <br /> (916) 371 -5747 <br /> p CAD044003556 <br /> 0 " � � � ' � � ® � ® � � SERVICE <br /> ' ,. � ORDER NO. �. � 42 <br /> � � - p <br /> , _JEWV <br /> DATE �2 2 !L JOB NUMBER <br /> GENERATOR �� S `� i ` - ✓L `� C ,�t� �I y' L'� VC�L Ce�� . GENERATOR EPA <br /> BILLING ADDRESS <br /> AMOUNT (IF ANY) <br /> GENERATOR CONTACTLCHECK NUMBER <br /> PHONE :4ti ? Sti P. O. NUMBER <br /> CASH RECEIVED (amt.) <br /> JOB SITE ADDRESS �'y �� y I"��� �'; <br /> v alit to S <br /> t HALIDES zlr� .)Q P.P. M . <br /> JOB DESCRIPTION LI t � '_-� � � L <br /> MATERIALS <br /> j ElNON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE # _ 2 START TIME <br /> ARRIVE TIME t '� <br /> j NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE # ' <br /> LEAVE JOB <br /> ❑ U . S . DOT DESCRIPTION : STOP TIME <br /> ❑ <br /> E <br />' (USED ANTI-FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # <br /> USED OIL FILTERS DRUMS <br /> r <br /> MANIFEST NO. � 4 " � NO. OF GALLONS <br /> n <br /> DRIVER 'S SIGNATURE '--"� 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 15 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 and correct. <br /> NATURE <br /> 24 Hour Emergency Response Team : 1 - 800456 - 7745 �-t�% <br />