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Safety - Kleen relies on Customer ' s representations and Customer is <br /> responsible for informing Safety - Kleen of any process changes that may <br /> alter the characteristics of the materials provided . IN THE EVENT OF <br /> AN EMERGENCY CALL **24 -HR NUMBER** 1 -800 - 468 - 1760 (Safety- Kleen) A <br /> variable recovery fee that fluctuates with the DOE national average <br /> diesel price may be applied to your invoice . For more information <br /> regarding our recovery fee calculation please go to <br /> http : //safety - kleen . com/ <br /> customer - service/environmental - fees/recovery- fees . Please note <br /> e-manifest fees applicable to this order may not be included in the <br /> total above and will be included in the final invoice or credit card <br /> statement . RECEIPT ONLY - THIS IS NOT AN INVOICE '.... <br /> I have established a program to reduce the volume or quantity and <br /> toxicity of the haZardOUS waste to the degree to be economically <br /> practicable . <br /> Signature <br /> CUSTOMER / GENERATOR : ricardo ocampo <br /> Signature <br /> TRANSPORTER : Brandon 3 Gaither <br /> CSG SK -SSL -BOX- 21 Brandon 7 Gaither 11 /12/19 13 : 02 PAGE 2 <br /> SHIPPING DOCUMENT <br /> IN THE EVENT OF AN EMERGENCY CALL **24 -Hr -Number** 1 -800 - 468 - 1760 (Safety- Kleen) <br /> REFERENCE NBR . <br /> CUSTOMER#/GENERATOR : SKOSS10 SKS 81587512 - 1905961954 <br /> 18832 Mello Rd <br /> Ripon CA 953664601 <br /> PHONE 209 -599 -409S <br /> GENERATOR USEPA I0 . CAL000061579 GENERATOR STATE <br /> MANIFEST# : 007318070SKS FORM CO : ID SHIP# 229921522 <br /> TRANSPORTER 1 TXROOOOS1205 Safety Kleen <br /> 5050 eALIDA BLVD <br /> SALIDA , CA. 95368 <br /> TNSP PHONE : 209- 545 - 1011 <br /> TRANSPORTER 2 <br /> US DOT Ots( HIP"TION (INCLUDING PROPER SHIPPING NAME , HAZARD CLASS , AND ID) ' <br /> NON -RCRA HAZARDOUS WASTE , SOLID <br /> ( )RAINED/UNDRAINED USED OIL FILTERS) '.. <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 223 <br /> TOTAL CONT 1 TYPE DM W `/VOL P SKDOT 7872676 <br /> CNT#: 191106834847 SZ : 30 GAL/114 L CONTAINERS QTY : 100 PROF# 156033 C. <br /> DESIGNATED FACILITY NAME/ADDRESS : <br /> THERMO FLUIDS INC <br /> 12533 SE CARPENTER DR <br /> CLACKAMAS OR 97015 -8988 <br /> 750 PHONE : 503 - 788 - 4616 <br /> FACILITY USEPA ID NO ORQOOOOZ5197 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 0 -220 lbs/month <br /> a <br /> -- Signature <br /> CUSTOMER / GENERATOR : ricardo ocampo <br />