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Jan. 12. 2012 9:23AM No, 6103 P. 2 <br />Roos Environmental Servicle <br />E 1515 South River Rd. <br />West Sacramento, CA 95691 <br />(916) 371-5747. <br />CAD044003556 <br />I&LEAWAQ 4 : <br />A-111P991A IFA-'] I zi <br />DATE <br />GENERATOR Chase Chevrolet <br />BILLING ADDRESS <br />GENERATOR CONTACT Gay <br />PHONE 209-475-6630 <br />JOB SITE ADDRESS 6441 Holman Ar kion 95212 <br />JOB DESCRIPTION <br />MATERIALS <br />FW COMBUSTIBLE LIQUID, N.O.S., - NA1993,111, (USED OIL) CODE # _ `2A— <br />NON RCRA HAZARDOUS WASTE. SOLID -LIQUID CODE # . <br />0 U.S. DOT DESCRIPTION: <br />Q (USED ANTI -FREEZE) NDN RCRA HAZARDOUS WASTE LIQUID <br />MANIFEST NO. <br />DRIVER'S SIGN <br />CODE # <br />®RDERNo. 120666 <br />JOB NUMBER <br />GENERATOR EPA # CAL 000 117 545 <br />AMOUNT (IF ANY) <br />CHECK NUMBER <br />P.O. NUMBER <br />CASH RECEIVED <br />(amt.) <br />HALIDES _/ 10ag P,P.M- <br />STARTTIME �'190 <br />END TIME —„u <br />USED OIL FILTERS// DRUMS <br />NO, OF GALLONS 06 <br />TRUCK # " �— <br />DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES, 1615 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 />Thle 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 regulallons 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 [heir 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 produce used oil Into <br />recycled oil. <br />Terms - net 15 days. <br />After due date, a finance charge of 1.50% per month, 16.001/1. annual rate, will be charged on the unpaid balance. The customer agrees to pay reasonable <br />costs and allornev fees Incurred In the collection of this obligation. Venue for purposes of enforcement of this obligation shall be Yolo County. <br />I declare, under penally of perjury that the foregoing Is true and correct. <br />