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Ross Roberts Truck Repair Inc. 641 S Harrison Stockton, CA 95203 Record ID# PR0514497 <br /> Date of Inspection: 05/20/2021 Program: HW generator HMBP <br /> PLEASE PAY FROM THIS INVOICE TAUClC# CONTACT NAME t <br /> # ROUTE# <br /> Customer EPA# Date' GUSTotdER F-PA# <br /> Driver EPA#CAL 913534912 State Manifest Document# NEXT S>RVICG HATE <br /> CHP#CA88940 <br /> SACRAMENTO WASTE OIL FILTERS <br /> 4504 Dunnbury Way-Sacramento,CA 95842 <br /> (916) 344-1434 <br /> Transporters Registration No:3130 INVOICE NO. <br /> CO.NAME <br /> PHONE <br /> ADDRESS _ # OSAL INFORMATION <br /> p i J W AST>=DISP <br /> CITY STATE ZIP USED OILJMIfv)OILSI <br /> `TE,LfQUID( GLYCOL SOLUTIONS) <br /> QTY DESCRIPTION <br /> PRICE TOTAL ;TE,LIQu10lETHYLENE <br /> 55 gallon drum of /per <br /> drained ail and gas filters '? drum ' E <br /> �, FACiLITY'.�� <br /> Y DRUMS:�� <br /> _ 55 gallon drum of ;/Y51.0 }� ?� - / r - Oty(PLEASE C}il <br /> oil absorbant material TOR WASTE CEFITIFICA <br /> MUST ctteck ONE <br /> rlcus er ta,halide° "a <br /> tom amen <br /> Empty Drums �iI9 hazardous waste,-to determine thisi <br /> generator <br /> to 5h. <br /> bed a0°e W Ith anY olh a�agernent regulation <br /> v <br /> de Calllnmla used ell m Ilde coolant i <br /> to Is incorrect total ha t <br /> Iib anq nthai BS l°rebutW ast¢,1h0 tnel lois was <br /> a d the PresumPlion <br /> bed anove TM' ta15¢ry c this waste is lnconect <br /> t oil Envlronmen l Nded about <br /> ve P° or condition° <br /> - SormaOcn I ha 04Y1 endl <br /> ' it lrom ahold"d S s°Iev Rom DI andl, ion vet <br /> nous "dja,tion I ha <br /> .Y pIYItGESo'.11 ctlo p50ti bt[lits waste 11 the <br /> dISP US <br /> .,nioaatohats eneratorsf customers M <br /> AIC, 1 waste 9eneSt°d to the deems I l <br /> (Alt! s the Present <br /> ,uce the volume andevadable to me whicn minim.Ze that neI' <br /> Service Charge dlsPoaa is en <br /> ants to acca <br /> DESTINATION OF InbehaItoicustomaereadl o lrans4ota,ion <br /> OIL FILTERS "�~ ayed m,,wed,31 thtseservlce 0,der. <br /> TOTAL~ or coos 0'r <br /> o a"u,0 <br /> side °us b <br /> .,p¢ieve[se t er alta speCtt1'eeswlll appear on Y <br /> 23271 Eichler St. ,us waste an Ses(.0t0:.Applicable <br /> Hayward,CA 94544 <br /> �Based on <br /> J <br /> Driver Signature � date <br /> Customer Signature <br /> 124 <br /> Term net 10 days.Finance charge 00 Fe w ll be charged forretumed checksnts not paid within 30 days. <br /> �. <br /> f � <br /> IMG 0172: Hazardous waste manifest of diesel soot, on 12/10/18. <br /> Frederick Ernest, EHS Page 30 of 30 <br />