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TRANSPORTER: Raymond Gomez CSG SK-SSL-ROX-Z3 Raymond Gomez 12/11/18 11:23 PAGE SHIPPING D�CUMEIdT REFERENCE NBR, CUSTOMER#/GENERATOR: DES4220 Delgado Auto 785259224805902265 101 W Dr Martin Luther King ]r Blvd Stockton CA 95206-1703 PHONE 760-579-1533 GENERATOR USEPA ID. CAL000404553 GENERATOR STATE FIANIFEST#: 006687678sks FORM CO: 1D SHIP# 227030864 TRANSPORTER 1 TXR000081205 SAFETY-KLEEN SYSTEMS, INC. SOSO SALIDA BLVD SALIDA,CA. 95368 TNSP PHONE: 209-545-1011 TRANSPORTER 2 US DOT DESCRIPTION CINCLDDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID) NON-RCRA HAZARDOUS WASTE, LIgUID (AQUEOUS PARTS WASHER SOLUTION) FEDERAL WASTE CODES NONE STATE WASTE CODES 134 TOTAL CONT 1 TYPE DN WT/VOL G SKDDT 14941 CNT#: 181117997765 SZ: 30 GAL/114 L CONTAINERS QTY: 20 PROF# 156023 DESIGNATED FACILITY NAME/ADDRESS: SAFETY-KLEEN SYSTEMS, INC. 6000 88TH STREET SACRAMENTO CA 95828 TSD PHONE: 916-386-4913 FACILITY USEPA ID NO CA0000084517 FACILITY STATE ID NO GENERATOR STATUS q-220 lbs/month Customer certifies ttrat (i) the above-named materials are properly classified, packaged, marked and labeled, and are in proper condition for transportation according to the applicable regulations of the Oapartment of Transportation (ii) no material change has occurred either in the characteristics of the waste/material or in the process generating the waste/material, and (iii) the above referenced Generator Status is correct. Customer agrees to pay the above charges and to be bound by the terms and conditions (1) set forth in (a) the General Terms and Conditions provided separately to Customer or (b) any SK agreement signed by Customer and SK, and (2) incorporated herein by reference. Unless otherwise indicated in the payment received section, SK is authorized to charge Customer's account for this transaction. If Customer fails to make payment when due, an amount equal to the lesser of (i) 1.5% per month (18% per annum) or (i i) the maximum amount allowed by law, will be added to all unpaid amounts outstanding. Customer certifies that the individual signing this Service Acknowledgement is duly authorized to sign and bind Customer. Customer acknowledges that it is responsible for maintaining its Generator Status and obtaining an EPA ID number if required by applicable law. The following provision is applicable to Safety-Kleen's parts cleaner and paint gun cleaner services: Customer agrees that it will not introduce any substance into the solvent or aqueous cleaning solution, including without limitation any hazardous waste or hazardous waste constituent, except to the extent such introduction is incidental to the normal use of the machine. Customer further agrees that it will not clean parts/paint guns that have been contaminated with or otherwise introduce polychlorinated biphenyls (lrcB's), herbicides, pesticides, dioxins or listed hazardous waste into the solvent or aqueous cleaning solution. Safety-Kleen has the capacity and is permitted to accept, store, and/or reclaim the spent pnrts washer solvent; paint thinners, solvents and paints generated by customer; or dry cleaning filter cartridges, powder, and still residues containing perchloroethylene, petroleum naphtha, or tri flurotrichloroethane dry cleaning solvents. Customer agrees that it is responsible for properly classifying its waste streams as Used Oil ar Nonhazardous Waste in accordance with the provision of 40 CFR 262.11 and applicable state laws. Customer agrees that it will not introduce any non -conforming substance into the SK Property, including, without limitation, any hazardous waste or hazardous waste con stituent,(i.e., polychlorinated biphenyls ("PCBs"), herbicides, pesticides, dioxins, or listed hazardous wastes) except to the extent such introduction is incidental to the normal use of the SK Property. In the event of the introduction of such non -conforming hazardous waste, Customer agrees that it will be responsible for all costs and remediation expenses related to or arising from the proper management and disposal of the non -conforming waste, including the cost of equipment decontamination and subsequent disposal. Final invoicing wilt be based on the actual services provided, which may include additional charges for off specification waste and surcharges. Final invoice amount may be more than the amount listed on the printed receipt. If any legal action is commenced because of an alleged dispute. breach. default or misreoresentation. the C11StAh1&P alsn