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Jan, 12. 2012 9:24AM <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 Ga <br />PHONE 209-475-6630 <br />JOB SITE ADDRESS 6441 Holman Dr. StOCkton 95212 <br />JOB DESCRIPTION <br />MATERIALS <br />0 <br />No. 6103 P. 8 <br />RDER No. 121479 <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 />(amt.) <br />HALIDES P.P.M_ <br />XCOMBUSTIBLE LIQUID, N.O.S., - NA1993, 111, (USED OIL) CODE # 2 <br />NON RCRA HAZARDOUS WASTE. SOLID -LIQUID CODE # <br />STARTTIMi: <br />U.S. DOT DESCRIPTION' END TIME—�' <br />F] (USED ANTI -FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # USED OIL FILTERS 0 UMS <br />MANIFEST NO. �V *07� -} NO. OF GALLONS <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 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 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 wlll be transported only to a facility permitted by the Slate of California to produce used oil Into <br />recycled oil, <br />Terms - net 16 days. <br />After due date, a finance charge of 1,60% per month, 18.00% annual rate, will be <br />costs and attorney fees Incurred in the collection of INS obligation. Venue for pur <br />I declare, under penalty of perjury that the foregoing Is true and correct. <br />rj <br />ad on the unpaid balance. The customer agrees to pay reasonable <br />of enforcement of this obligation shall be Yolo County. <br />GENERATOR SIGNATURE n _,--/ -�,' / ^ <br />