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CSG SK-SSL-UMO-G Joseph R Lino Jr 05/18/17 11:45 PAGE 2 <br /> SHIPPING DOCUMENT 41-5 C1 <br /> REFERENCE NBR. <br /> CUSTOMER-/GENERATOR: SA12602 Sanborn Chevrolet 73798333 <br /> 1110 S Ch.rokee Ln <br /> Lodi CA 95240-5994 <br /> PHONE 559-479-2632 CONTACT NAME: Sanborn Chevrolet <br /> GENERATOR USEPA ID. CAUOS4598289 GENERATOR STATE <br /> MANIFEST/: 006099716SKS FORM CD: 1D SHIP.212411145 <br /> TRANSPORTER 1 TXR000081205 SAFtTY-►LEEN SYSTEMS, INC. <br /> SOSO SALIDA BLVD <br /> SALIDA,CA. 95368 <br /> TNSP PHDNE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US U01 ULS(RIPIION LINLLUULNG PRUVIH SHIPPING NAME, HAZAHO LLASS, -0 111) <br /> NON-RCRA HAZARDOUS WASTE. LIQUID <br /> (USED OIL) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 221 <br /> TOTAL CONT I TYPE IT WT/VOL G SKOOT 11249 <br /> CNIS: 170518151152 S/: BULK VOLUME CONTAINER QTY: 110 PROF. I"Oil (A <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLEEN OF CALIFORNIA <br /> 6880 SMITH AVE. <br /> NEWARK CA 94560 <br /> TSO PHONE: SIO-79S-4400 <br /> FACILITY USEPA ID NO CAD980807418 <br /> FACILITY STATE ID NO <br /> If high risk sourcI.P. certifies that load specific PCB L Silicon <br /> testing have beencomyleted prior to pumping this load. <br /> GENERATOR STATUS <br /> SQG/LQG: Vehicle <br /> Cust.nirr tarsiIles that (i) thr above-n•nwd nwteri.ls•e properly <br /> cl•ssi/ieJ, V•alayed, ualrk eJ..I labeled, and• n proper condition <br /> for transportation a ording to the applicjbl. regulations of the <br /> D.yartn,.nt of Tr...,art.tion (i i) n material ch..V.has occurred <br /> either in the c h....terist i<s of[he w st-Awal-ri•l o n the rpr..... <br /> yenerat my the waste/material, and (iii) the above referenced <br /> Generator Status i c act. Customer•y tees to pay the above ch.rges <br /> and to be Lound bystherlernrs and conditions (I) set forth in (a) the <br /> General Terms and Conditions provided seyar.tely to Custwner ar led("any SK aY retment signed by Cust o'-r and SK, and (2) i ary...ted <br /> herein by rt/e tante. Unless otherwise indicated in the Payment <br /> e< ped sectio., SK is au thori.ed to charge Cust wneis a ant for <br /> this i transaction. If Custom, r fails to—he P.yment when due, <br /> int eq u•1 to the lesser of (i) 1.54 per month (184 per annw,J or <br /> (ii) the m nm unt allowed by Lw, rill be added to all unpaid <br /> thiants outetmJiny�Custwner certifies tliat the i.Jividual signing <br /> s Service Acle...l.dya nt is July.uthoriaeJ to sign and bind <br /> Custanrr. Customer •Lk...ledges that it is responsible fur,. in t.i„iny <br /> its Generator Status and obtaining.a EPA ID n,nber if repo ireJ by <br /> +pylic able law. The following provision i applicable to <br /> Safety-Kleen's parts cleaner and paint Vun cleaner s Cuslonier <br /> agrees s that it will not introduce any substance in tae thecsolvent o <br /> ague clu illy solution, including witLaut limitation any h.a•rd... <br /> .steuor ha.ardous wast, --tit..nl, a 1.,t to the e.tent such <br /> introduction i cident•lto the n rural u o1 the machine. Cusco—r <br /> further ayreeasth•t it will nut clean parts/ya int guns that have been <br /> <ont-4-1:1 with o otherwise introduce pillychlor in•itd biphenyls <br /> PCB's), he rb is iJesr Vest is ido, dio:ins or listed huardous waste <br /> into the..1,ent o aqueous cleaning solus ion. Safety-Nleen has the <br /> capacity and is permitted to•ccep t, store, and/or ec la La the spent <br /> Parts washer solvent; paint thinners, solvents and pines yoated Ly <br /> useomer; or dry clean illy filter cartridges, pun r, and still, <br /> of idues contain illy pe rchloro<thylene, Prlrale,ni naphtha, or <br /> triflurutrichloruethane dry cltu,iny solvents. Cost w„er•yrees th.t it <br /> esponsible for properly classi(yiny its waste.eters.as Used Oil <br /> it NunhatarJous Wu to i orJance Witt the provision of 40 CFR <br /> 26Z.Ii and apps is able sta tecta.... Custwner ay roes tlu[ it will not <br /> introduce any nen- onfoi,,dng substance into the SK Properly, <br /> wcludiny, withoutcl lin itation, any haAardo,4s wast. ar haAe"uus waste <br /> nst i[uent,(i.e., polychlorinated biphenyls ("PCBs'"), herL is ides, <br /> pesticides, dio.in s, or listed halard...wastes) .ccep[ to the..lent <br /> b introduction i cidental to then m•1 u of the SK Property. <br /> In the a ant of then introduction of suchen —I m,i. hoe.rdous <br /> ate, Customer•yrees that it will be respells ibl. far all costs and <br /> „ediatiwn..yens rel.ted to o my frau the proper n n•Vemmnt <br /> and disposal of thesn n-confunning.&sit, including the costof <br /> e9u iPnent decent rninat ion id suL+equent Jispos.l. final invoicing <br /> w T1 be based on the actual services yravi Jed, which nay include <br /> dditional charges fur off specification waste•nJ s rcharyes. Fin•1 <br /> inv •roust m.y be m e than th. r ant listed,.nuthe printed <br /> rece ip t. If any loyal action is cwnnen�c•d because of an alleged <br /> dispute, brant h, de/welt or <br /> reyresentatian, the lust weer o <br /> r sDoaalso <br /> •yrees that the pre p-it illy yar11 rill be entiled to —o <br /> r <br /> ble-it Fees and costs• iated with the <br /> union ntrninat lull <br /> .—t. sale tY-Klaen'> failure la s <br /> C..tw,.r's -teri.l or take•retain sample, T way c nstitulesee <br /> of Custainer's abliyAt_ to grave rly Ll.S.i , itson,aterials. <br /> Safely-Kleen relies on Cust...is r.present.tons and Custw,er ti <br /> esponsible far informinV Safety-Kleen of any'process changes that stay <br /> alter the characteristics of the maleri.ls provide J. IN THE EVENT OF <br /> AN EMERGENCY CALL ••24-HR NUMBER•• 1-800-468-1760 LS•ftty-Klten) <br /> I halt established a yragrrn tv reduce ibt valwoe ar quantity and <br /> to, <br /> city of the li—rdous waste to the degree to be econwnically <br /> practic.ble. �•+�� + <br /> I'aa� <br /> MAY 19 2017 <br /> ENVIRONNIENTAL HE,�LTH <br /> DERARTMENT <br />