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Jan, 12. 2012 9:23AM <br />No, 6103 P. 4 <br />Roos Environmental Siarvic <br />1515 South River Rd. <br />West Sacramento, CA 95691 <br />(916) 371-5747 INVOICE # <br />CAD044003656 <br />DATE ' A l <br />GENERATOR Chase Chevrolet <br />BILLING ADDRESS <br />GENERATOR CONTACT Cary <br />PHONE (209)475-6630 <br />JOB SITE ADDRESS 6441 Holman Drive Stockton, CA 95212 <br />JOB DESCRIPTION <br />'� /r <br />MATERIALS <br />ORDER No. 120944 <br />JOB NUMBER <br />GENERATOR EPA # CAI. 000 117 545 <br />AMOUNT (IF ANY) <br />CHECK NUMBER <br />P,O. NUMBER <br />CASH RECEIVED <br />HALIDES <br />(amt.) <br />P.P.M. <br />Z 'COMBUSTIBLE LIQUID, N.O.S., - NA1993, III, (USED OIL) CODE # 'U i <br />NON RCRA HAZARDOUS WASTE. SOLID -LIQUID CODE # START TIME.�L/ "3) <br />El U.S. DOT DESCRIPTION: END TIME <br />(USED ANTIFREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # USED OIL FILTERS 4ZRUMS <br />MANIFEST NO_ NO, OF GALLONS 11'e <br />� <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 1000 RP.M. <br />This Is to cerlify 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 cerlify 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 faclilly <br />via Ramos' standardized permitted storage faclllty. <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 16 days. <br />After due date, a finance charge of 1.50% per month, 18.00% annual rale, will be charged on lthrwf aid balance. The customer agrees to pay reasonable <br />costs and attorney fees incurred In the collection of this obligation. Venue for purposso,f enfo cem nt of this obligation shall be Yolo County. <br />I declare, under penalty of perjury that the foregoing Is true and correct. <br />ii <br />TOR SIGNATURE <br />