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Ramos Environmental Services <br /> 1515 South River Rd . <br /> West Sacramento , CA 95691 <br /> ' (916) 371 - 5747 <br /> " - CAD044003556 <br /> tt 11 ,1 X20 SERVICE <br /> SERVICE ORDER ORDER NO, 17 6 217 0 <br /> 1 L OF LADING <br /> e � <br /> DATE — � p JOB NUMBER <br /> GENERATOR \:6UaVnACIJ/ l �CJ. GENERATOR EPA # C& <br /> BILLING ADDRESS <br /> � AMOUNT (IF ANY) <br /> GENERATOR CONTACT �_u-��-b 19 ajo CHECK NUMBER <br /> PHONE C� P.O. NUMBER <br /> JOB SITE ADDRESS CASH RECEIVED (amt.) <br /> j OV. HALIDES fC`3CC� P. P. M . <br /> j JOB DESCRIPTION 5 07 iA- oO 13 "y � &em /o l p iq _�� oz <br /> MATERIAL ' L 4 S Arm 55 <br /> 42 <br /> START TIME <br /> MON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE # � Z� <br /> _... ARRIVE TIME <br /> NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE # _ <br /> LEAVE JOB 3 : 00!' <br /> 0 U . S. DOT DESCRIPTION : STOP TIME <br /> EfUSED ANTI-FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE #k USED OIL FILTERS DRUMS <br /> MAN � ' 5V3 (5 TJ /Z -` 0 - X0ZIV53 t NO. OF GALLONS <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 /> 3 <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 /> X <br /> GENERATOR SIGNATURE <br /> 24 Hour Emergency Response Team : 1 - 800 -450 - 7745 01100 Li <br />