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Jan, 12. 2012 9:23AM <br />Environmental Service <br />1515 South River Rd, <br />West Sacramento, CA 95691 <br />(916) 371-5747 <br />CAD044003556 <br />DATE <br />GENERATOR Chase Chevrolet <br />BILLING ADDRESS <br />GENERATOR CONTACT Ca <br />PHONE -475-6630 <br />JOB SITE ADDRESS 6441 Holman Dr. Stockton 95212 <br />JOB DESCRIPTION <br />MATERIALS <br />n COMBUSTIBLE LIQUID, N,O.S-, - NA1983, 111, (USED OIL) CODE # -- <br />NON MCRA HAZARDOUS WASTE. SOLID LIQUID CODE # <br />U.S. DOT DESCRIPTION: <br />F] (USED ANTI -FREEZE) NON FiCRA HAZARDOUS WASTE LIQUID <br />MANIFEST N0, <br />DRIVER'S SIGNATURE <br />k 6103 P, 3 <br />INVOICE <br />ORDERNO, 120792 <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 />HALIDES — P.P.M. <br />START TIME <br />END TIME _4L -d _C1 <br />CODE # — USED OIL FILTERS DRUMS <br />NO. OF GALLONS S> !O <br />TRUCK # ^ —W <br />-/-, C", _ - <br />DESIGNATED TSDF' RAMOS ENVIRONMENTAL SERVICES, 1515 SOUTH RIVER RD. WEST SACRAMENTO 95691 CAD 044003556 <br />I HEREBY CERTIFY THAT 1 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 Transportatlon. <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 economlcally 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 produce used oil Into <br />recycled oil. <br />Terms - net 15 days. <br />After due date, a finance charge of 1.50% per month, 18.00% annual rale, will be charged on the unpaid balance, The customer agrees to pay reasonable <br />bligation shall be Yoto County, <br />costs and attorney fees Incurred In the collection of this obligation. Venue for purpo�s of enforcement of this o <br />I declare, under penalty of perjury that the foregoing is fte and correct. <br />Q <br />M <br />Lki <br />