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' Qamos Environmental Ser.,`-ges <br /> 1515 South River Rd. <br /> West Sacramento, CA 95691 <br /> .� (916) 371-5747 <br /> ►+ CAD044003556 <br /> SERVICE <br /> SERVICE ORDER ORDER NO. 169560 <br /> BILL OF LADING <br /> DATE "' -I` / JOB NUMBER <br /> GENERATOR _ � C� ��ut �csr� GENERATOR EPA # <br /> BILLING ADDRESS <br /> AMOUNT (IF ANY) <br /> GENERATOR CONTACT S h L z7D CHECK NUMBER <br /> 1 C — (- <br /> PHONE r P.O. NUMBER <br /> JOB SITE ADDRESS ' CASH RECEIVED (amt.) <br /> � � L <br /> HALIDES P.P.M. <br /> JOB DESCRIPTION <br /> MATERIALS <br /> NON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE# � START TIME � <br /> NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE # ARRIVE TIME <br /> F] <br /> LEAVE JOB Tr <br /> U.S. DOT DESCRIPTION: <br /> STOP TIME ` <br /> (USED ANTI-FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE# USED OIL FILTERS DRUMS <br /> MANIFEST NO. NO. OF GALLONS 67-e?U <br /> DRIVER'S SIGNATURE TRUCK# 1� <br /> DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES. 1515 SOUTH RIVER RD. WEST SACRAMENTO 95691 CAD 044003556 <br /> „ ,J 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 /> X � <br /> GENERATOR SIGNATURE , <br /> 24 Hour Emergency Response Team: 1 -800-456-7745 <br />