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Jan, 12, 2012 9; 23AM <br />Rqoos Environmental Servicia. <br />1515 South River Rd. <br />West Sacramento, CA 95691 <br />(916) 371-5747 <br />CAD044003556 <br />No, 6 10 3 P, 7 <br />SERVICE ' <br />ORDER NO. 121344 <br />DATE r , ®� ®� JOB NUMBER <br />GENERATOR Chase Chevrolet GENERATOR EPA # CAL 000 117 545 <br />BILLING ADDRESS <br />GENERATOR CONTACT Ga <br />PHONE -475-663 <br />JOB SITE ADDRESS 6441 Holman Dr. Stockton 95212 <br />JOB DESCRIPTION <br />MATERIALS <br />XCOMBUSTIBLE LIQUID, N.O.S., . NA1893, 111, (USED OIL) CODE # <br />n NON RCRA HAZARDOUS WASTE_ SOLID - LIOUID CODE # <br />El U,S, DOT DESCRIPTION, <br />(USED ANTI -FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # <br />MANIFEST NO. <br />DRIVER'S SIGNATURE <br />AMOUNT (IF ANY) <br />CHECK NUMBER <br />P.O. NUMBER <br />CASH RECEIVED <br />(amt.) <br />HALIDES ® () P.P.M. <br />START TIME <br />END TIME <br />USED OIL FILTERS DRUMS <br />NO. OF GALLONS <br />t-� < L <br />TRUCK # uT <br />DESIGNATED TSDF; RAMOS ENVIRONMENTAL SERVICES_ 1515 SOUTH RIVER RD, WEST SACRAMENTO 95891 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 />This Is to certify that the above named articles are properly classified, described, packaged, marked and are in proper condition for <br />transporlatlon, according to the applicable regulations of the Department of Transportation. <br />Generator's Cerilllcatlon' 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 produce used oil into <br />recycled oil. <br />Terms - net 15 days. <br />After due dale, 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 />1 declare, under penalty of perjury that the foregoing is true and correct. <br />X <br />_ RaTOft 61 TUBE <br />