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ANSPOKIcn: JuscPu n ..,i -• <br /> CSG SK-SSL-UMD-01 Joseph R Lima ]r 07/16/18 09:45 PAGE 2 <br /> SHIPPING DOCUMENT REFERENCE NBR. <br /> CUSTOMER#/GENERATOR: SA32680 San Hazelton 3oaquin Co <br /> Maintenance 77394203-1803549826 <br /> 1810 E <br /> Ave <br /> Stockton CA 95205-6232 <br /> PHONE 209-468-3099 <br /> GENERATOR USEPA ID. CALD00015838 GENERATOR STATE <br /> MANIFEST*: 01183707Df1e FORM CD: 10 SHIP# 225970495 <br /> TRANSPORTER 1 TXRO00081205 SAFETY_ <br /> XLEENSSYSTEMS,I C <br /> SALIDA,CA. 95368 <br /> MSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US DOT DESCRIPTION CLTICLUDING PROPER SHIPPING NAME, HAZARD CLASS. AND ID) <br /> NON-RCRA HAZARDOUS WASTE, LIQUID <br /> (USE) OIL) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 221 <br /> TOTAL CONT 1 TYPE TT WT/VOL G SKDOT 11249 <br /> CNT#: 180716538417 SZ: BULK VOLUME CONTAINER QTY; 270 PROF# 156017 CA <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLEEN OF CALIFORNIA <br /> 6880 SbJITH AVE. <br /> NEWARK CA 94560 <br /> TSD PHONE: 510-795-4400 <br /> FACILITY USEPA ID NO CAD98GS37419 <br /> FACILITY STATE IO NO <br /> If high risk source, rep. Certifies that load specific PCB 8 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 /> erabove charges <br /> Generator Status is correct. Customer agrees to pay <br /> and to be bound by <br /> the terms and conditions (1) set forth in (a) the <br /> General Terms and Conditions provided separately to Customer 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. SK is authorized to charge Customer's account for <br /> this transaction. If Customer fails to make payment when due, an <br /> amount equal to the lesser of (i) 1.5% per month (IS% per annum) or <br /> (ii) the maximum amount allowed by law, Will be added to all unpaid <br /> amounts 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 far maintaining <br /> its Generator Status and obtaining an EPA IO 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 /> wash ar hazardous waste constituent, except to the extant such <br /> o the normal use of the machine. Customer <br /> introduction is incidental t <br /> not clean parts/paint guns chat have been <br /> further agrees that it will <br /> contaminated with or otherwise introduce polychlorinated biphenyls <br /> (PCB's), herbicides, pesticides, dioxins or listed hazardous waste <br /> into the solvent or aqueous ns- <br /> cleaning solutioSandjoafetyec leenaimthassthe <br /> pent <br /> capacity and is permitted to accept, store. <br /> parts washer solvent; Paint thinners, solvents and paints generated by <br /> _.cuctam'r.� nr.Anv rlrani..n fil t.r c:.•t..+•I^�� <br />