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CSG SK-SSL-60#-23 Raymond Goinez 03/19/18 I4:33 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR. <br /> CUSTDMER#/GENERA"IUR: SA32680 San Joaquin Co Maintenance 76311556-1801213235 <br /> 1810 E Hazelton AW .-- <br /> Stockton CA 95205-6232 <br /> PHONE 209-468-3099 <br /> GENERATOR USEPA 20. CALODOO15938 GENERATOR STATE <br /> MANIFEST#: 006462932sks FORM CO: 1D .SHIP# 224921075 <br /> SRP.kSPORTER 1 TXR490061205 SAFETY-KLEEN SYSTeMS, INC. <br /> - 5950 SALIDA BLVD <br /> SAI A,CA. 95368 <br /> TNSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US 001 DESCRYP110N (,LNCLUDINL PROPL9 SHIPPING NXIt. HAZARD CLASS, AND LL)) <br /> NON-RCRA HAZARDOUS WASTE, SOLID <br /> ORAINED/UNDRAI:NED USED OIL FILTERS) <br /> FEDERAL WASTE CODES NONE _ <br /> STATEWASTECODES 223 ' <br /> TOTAL CONT 1 TYPE DM WT/VOL P SHOOT 7872676 <br /> CNl#., 180308472388 SZ: SS GAL/205 L CONTAINERS QTY: 300 PROF# 156033 C. <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> THERMO FLUIDSINC - <br /> 12533 SE CARPENTER OR <br /> CLACKAMAS OR 97015-8988 <br /> TSD PHONE: 503-768-4616 <br /> FACILITY USEPA ID NO OR0000025197 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 0-220 lbs/manth <br /> Customer certifies that (i) the abovt-naued materials are properly <br /> classified, packaged, marked and labeled, and are in proper condition <br /> for transportation aCCUrdirrg to Lite' applicable regulations of the <br /> Department of Transportation (ii) no material change has Occurred <br /> either in the CharacLeristics of the wdstt/nlateridl 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 CUSLanner-Or (b) <br /> any SK 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 Custolner's account Fur <br /> this transaction. If Customer fails to make payment when due, on <br /> amount equal to the lesser of (i) 1.55 per month (18% per annum or <br /> (ii) the mucin:um amount allowed by law, will be added to all unpaid <br /> a"u"nts outstdnding. Customer certifies thaL the individual signing <br /> this Service Acknowledgement is duly authorized to sign and hind <br /> Customer. Customer acknowledges that it is respollsible for maintaining <br /> its Generator Status and obtaining an EPA ID numlber if required by <br /> applicable law. Tire following provision is applicable to <br /> Safety-Kleerr's parts Cleaner and paint 91111 Cleaner services: CUst011ler• <br /> agrees that it will not introduce any SUhStauce into the solvent or- <br /> aqueous cleaning solution, including without limitation only 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 thdt it will not clean parts/paint guns that have been <br /> rantauinated with nr ntherwise intruducrpail vt,l"1 m•ingttrl biphK.0s <br /> (PCB'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, andfor rkcloim the spent _ <br />