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Ramos Environmental Services <br /> 1515 South River Rd . <br /> 1,411ECEIVED West Sacramento , CA 95691 <br /> (916) 371 -5747 <br /> AUG 2 7 2021 CAD044003556 <br /> ENVIRONMENTAL HEALTH SERVICE ORDER ORE'R NO. 171911 <br /> DEPARTMENT BILL O F LADING <br /> DATE \\ X622 Y'f ' JOB NUMBER <br /> GENERATOR �'��� `v m �2� « JQ �ko eu Irk �1'1c GENERATOR EPA # C k 94P <br /> BILLING ADDRESS <br /> AMOUNT (IF ANY) <br /> GENERATOR CONTACT CHECK NUMBER 3 7� 4/ <br /> PHONE P.O , NUMBER <br /> JOB SITE ADDRESS �� CASH RECEIVED (amt .) <br /> CAL �� - ` HALIDES L i nc P. P. M . <br /> JOB DESCRIPTION <br /> f f cernco Use A <br /> MATERIALS �.1E + r�� � x 6 ✓ U0% f <br /> 1200<0N RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE # 7' START TIME `4> f7 � <br /> ARRIVE TIME / • � 60 <br /> F1 NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE # � f <br /> LEAVE JOB <br /> F U .S. DOT DESCRIPTION: t STOP TIME Jii, 01" <br /> EKsED ANTI -FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # �'' USED OIL FILTERS DRUMS <br /> MANIFEST NO. n % q 1 "7' 9— 81pq •j IL- " Co l a 17 .2 So•(o :s J 6 NO. OF GALLONS G <br /> DRIVER 'S SIGNATURE l✓ TRUCK # <br /> DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES . 1515 SOUTH RIVER RD. WEST SACRAMENTO 95691 CAD 044003556 <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY OTHER WASTE, AND THE TOTAL HALIDES ARE LESS THAN 1000 P. P. M . <br /> This is to certify that the above named articles are properly classified , described, packaged, marked and are in proper condition for <br /> transportation , according to the applicable regulations of the Department of Transportation . <br /> Generator's Certification : I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practicable. Ramos agrees with the generator to send all their hazardous waste to an authorized hazardous waste treatment facility <br /> via Ramos' standardized permitted storage facility. <br /> All used oil collected from the generator listed above will be transported only to a facility permitted by the State of California to accept used oil. <br /> Terms - net 15 days. <br /> After due date, a finance charge of 1 .50% per month, 18.00% annual rate, will be charged on the unpaid balance. The customer agrees to pay reasonable <br /> costs and attorney fees incurred in the collection of this obligation. Venue for purposes of enforcement of this obligation shall be Yolo County. <br /> I declare, under penalty of perjury that the foregoing is true and correct. <br /> . <br /> GENERATOR SIGNATURE <br /> 24 Hour Emergency Response Team : 1 - 800 - 45 & 7745 <br />