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TRANSPORTER: Johnny Owens <br /> -- CSG SH-SSL-UMO-01 Johnny Owens IDJ12/18 10:48 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NOR. <br /> CUSTOMER#/GENERATDR: SA32630 San Joaquin Co Maintenance 78163871-1805164969 <br /> 1310 E Hazelton Ave <br /> Stockton CA 95205-6232 <br /> PHONE 209-465-3099 <br /> GENERATOR USEPA ID. CAI-000015839 GENERATOR STATE <br /> MANIFEST: 006776307SES FORM CD: 1D SHIP( 226696120 <br /> TRANSPORTER 1 TXROOOO81205 SAFETY-KLEEN SYSTEMS, INC. <br /> 5050 SALIDA BLVD <br /> SALIDA,CA. 95368 <br /> TNSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) <br /> NON-RCRA HAZARDOUS WASTE, LIQUID <br /> (USED OIL) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 221 <br /> TOTAL CONT 1 TYPE TT WTAOL G SKDOT 11249 <br /> CNTL`: 181012274761 57: BULK VOLUME CONTAINER QTY: 334 PROF« 156017 CA <br /> OFSIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLELN OF CALIFORNIA <br /> 6380 SMITH AVE. <br /> NEWARK CA 94560 <br /> TSO PHONE: 510-795-4400 <br /> FACILITY USEPA ID NO CAD980887415 <br /> FACILITY STATE 20 NO <br /> If high risk source, rep. certifies that load specific PCS 4, Silicon <br /> testing have been completed prior to pumping this load, <br /> GENERATOR STATUS <br /> CESQG: Vehicle <br /> Customer certifies that (i) the above--named materials are properly <br /> classified, packaged, marked and labeled, and 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/material or in the process <br /> generating the waste/material, and (iii) the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to be bound by the terms and conditions (1) set forth in (a) the <br /> General Terms and Conditions provided separately to Customer or (b) <br /> any SIC agreement signed by Customer and SK. and (2) incorporated <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section, SIC is authorized to charge Customer's account for <br /> this transaction. Xf Customer fails to make payment when due, an <br /> amount equal to the lesser of (i) 1.5% per month (1596 per annum) or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> Mounts outstanding. Customer certifies that the individual signing <br /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer. Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law. The following provision is applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br /> agrees that it will not introduce any substance into the solvent or <br /> aqueous cleaning solution, including without limitation any hazardous <br /> waste or hazardous waste constituent, except to the extent such <br /> introduction is incidental to the normal use of the machine. Customer <br /> further agrees that it will not clean parts/paint guns that have been <br /> contaminatad with or otherwise introduce polychlorinated biphenyls <br /> ('CB's), herbicides, pesticides, dioxins or listed hazardous waste <br /> into the solvent or aqueous cleaning solution. Safety-Kleen has the <br /> capacity and is permitted to accept, store, and/or reclaim the spent <br /> parts washer solvent; paint thinners, solvents and paints generated by <br /> customer; or dry cleaning filter cartridges, powder, and still <br /> residues Containing perchloroethylene, petroleum naphtha, or <br />