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CSG SK -SSL -BOX -23 Raymond Gomez 04/19/17 14:56 PAGE 2 <br />SHIPPING DOCUMENT <br />REFERENCE NBR. <br />CUSTOMER#/GENERATOR: T029125 Tower Park Marina 73481528 <br />14900 W Highway 12 <br />Lodi CA 95242-9514 SRVC DATE: 04/19/17 <br />PHONE 510-834-4591 CONTACT NAME: Tower Park Marina <br />GENERATOR USEPA ID. CAL000415593 GENERATOR STATE <br />MANIFEST#: 005947403SKS FORM CD: 1D SHIP# 222185406 <br />TRANSPORTER 1 TXR0O0081205 SAFETY-KLEEN SYSTEMS, INC. <br />5050 SALIDA BLVD <br />SALIDA,CA. 95368 <br />TNSP PHONE: 209-545-1011 <br />TRANSPORTER 2 <br />US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) <br />NON-RCRA HAZARDOUS WASTE, SOLID <br />(DRAINED/UNDRAINED USED OIL FILTERS) <br />FEDERAL WASTE CODES NONE <br />STATE WASTE CODES <br />TOTAL CONT 1 TYPE DM WT/VOL P SKDOT 7872676 <br />CNT#: 170412407325 SZ: 55 GAL/205 L CONTAINERS QTY: 100 PROF# 156033 CA CAT CODE:G <br />DESIGNATED FACILITY NAME/ADDRESS: <br />THERMO FLUIDS INC <br />4301 W JEFFERSON ST <br />PHOENIX AZ 85043 <br />TSD PHONE: 800-350-7565 <br />FACILITY USEPA ID NO AZR000003681 <br />FACILITY STATE ID NO <br />GENERATOR STATUS <br />0-220 lbs/month <br />Customer certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />for transportation according to the applicable regulations of the <br />Department of Transportation (ii) no material change has occurred <br />either in the characteristics of the waste/material or in the process <br />generating the waste/material, and (iii) the above referenced <br />Generator Status is correct. Customer agrees to pay the above charges <br />and to be bound by the terms and conditions (1) set forth in (a) the <br />General Terms and Conditions provided separately to Customer or (b) <br />any SK agreement signed by Customer and SK, and (2) incorporated <br />herein by reference. Unless otherwise indicated in the payment <br />received section, SK is authorized to charge Customer's account for <br />this transaction. If Customer fails to make payment when due, an <br />amount equal to the lesser of (i) 1.5% per month (18% per annum) or <br />(ii) the maximum amount allowed by law, will be added to all unpaid <br />amounts outstanding. Customer certifies that the individual signing <br />this Service Acknowledgement is duly authorized to sign and bind <br />Customer. Customer acknowledges that it is responsible for maintaining <br />its Generator Status and obtaining an EPA ID number if required by <br />applicable law. The following provision is applicable to <br />Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br />agrees that it will not introduce any substance into the solvent or <br />aqueous cleaning solution, including without limitation any hazardous <br />waste or hazardous waste constituent, except to the extent such <br />introduction is incidental to the normal use of the machine. Customer <br />further agrees that it will not clean parts/paint guns that have been <br />contaminated with or otherwise introduce polychlorinated biphenyls <br />(PCB's), herbicides, pesticides, dioxins or listed hazardous waste <br />into the solvent or aqueous cleaning solution. Safety-Kleen has the <br />capacity and is permitted to accept, store, and/or reclaim the spent <br />parts washer solvent; paint thinners, solvents and paints generated by <br />customer; or dry cleaning filter cartridges, powder, and still <br />residues containing perchloroethylene, petroleum naphtha, or <br />triflurotrichloroethane dry cleaning solvents. Customer agrees that it <br />Page 8 <br />