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Ramos Environmental Services <br />1515 South River Rd. <br />West Sacramento, CA 95691 <br />(916) 371-5747 <br />CAD044003556 <br />SERVICE ORDER <br />BILL OF LADING <br />DATE 1 S <br />GENERATOR < < \ 3 r <br />BILLING ADDRESS <br />/ <br />GENERATOR CONTACT <br />PHONE <br />JOB SITE ADDRESS <br />(\. nn� <br />SERVICE <br />ORDER NO. 169094 <br />JOB NUMBER <br />GENERATOR EPA #i. _•'\� <br />7/ / ��r --"� <br />AMOUNT (IF ANY) <br />CHECK NUMBER <br />P.O. NUMBER <br />CASH RECEIVED <br />(amt.) <br />HALIDES 4992 <br />/ P.P.M. <br />kNON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE # <br />r] NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE # <br />FJU.S. DOT DESCRIPTION: <br />(USED ANTI -FREEZE) NON RCRA HAZARDOUS WASTE LIQUID <br />MANIFEST NO. C I <br />STARTTIME <br />ARRIVE TIME <br />LEAVE JOB <br />��,, // � STOP TIME <br />CODE #,4D USED OIL FILTERS DRUMS <br />~ ' f ' NO. OF GALLO2NS <br />DRIVER'S SIGNATURE—� 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 10DO PP. 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 />t d/\�t�� Jf sj�rfdr(0 the collection of this obligation. Venue for purposes of enforcement of this obligation shall be Yolo County. <br />Il �,c , Olfder penlyattVoT erjuUry that the foregoing is true and correct. <br />MAY 25 2018 <br />X <br />ENVIRONMENTAL GENERATOR SIGNATURE <br />HEALTH D94TEmergency Response Team: 1-800-456-7745 <br />