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CSG SIC-SSL-BOX-23 Raymond Gomez 12,/04/19 13:18 PAGE 1 <br /> Safety-K een Systems, Enc , <br /> 2600 N Central Expy, Suite 200 <br /> n[tp:/�sarety-:eleen.com/ <br /> customer-service/environmental-fees/recovery-fees. Please note <br /> e-manifest fees applicable to this order may not be included in the <br /> total above and will be included in the final invoice or credit card <br /> statement. RECEIPT ONLY - THIS IS NOT AN INVOICIE <br /> I <br /> Y <br /> I have established a program to reduce the volume or quantity and I <br /> toxicity of the hazardous waste to the degree to be economically <br /> practicable. <br /> l <br /> Signature <br /> CUSTOMER / GEN£RATDR: bob mooney <br /> Signature <br /> TRANSPORTER: Raymond Gomez <br /> -------------------------------------------------------------------------------- <br /> CSG SK-SSL-ROX-23 Raymond Gomez 12J04/19 13:18 PAGE 2 <br /> SHIPPING DOCUMENT <br /> IN THE EVENT OF AN E:•1ERGENCY CALL --?4-Hr-Number** 1-800-468-1750(Safety-Kleen) <br /> REFERENCE NOR. <br /> CUSTOMER.',/GENERATOR: SA32680 San loaquin Co Maintenance 81314750-1906439734 <br /> 1810 E Hazelton Ave <br /> Stockton CA 95205-6232 <br /> PHONE 209-468-8540 <br /> GENERATOR USEPA ID. CALOGOOISS39 GENERATOR STATE <br /> MANIFEST4k: 007318058S1CS FORM CD: 10 SHIPS 230133644 <br /> TRANSPORTER 1 TXOOOOS1205 Safety IClee4 <br /> $050 SALXDA BLVD <br /> SALIDA,CA. 95368 <br /> TNSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 ' <br />