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CSG SK-SSL-UMO-01 30seph R Lima Jr 04/23/18 08:09 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR, } <br /> CUSTOMER#/GENERATOR: CA47958 Cal-Trans Shop 10- Lodi Cws 76587650-1601788910 ' <br /> 845 E Pine,St <br /> Lodi CA 95240-3108 <br /> PHONE 209-333-6953 <br /> GENERATOR {y$EP-k-M-.0 08w9824SS351 GENERATOR STATE <br /> MANIFEST#: 0065205 85K5 1 FORM CD: 1D SHIP# 225309597 <br /> TRANSPORTER-1 TmODOG81205 SAFETY-KLCEN SYSTEMS, INC. <br /> SOSO SALIDA BLVD <br /> SALIOA CA. 95368 <br /> 1NSP PHONE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US DOT DESCRIPTION (INCLOOING PROPER SHIPPING NAME, HAZARD CLASS, AND 10) <br /> NON-RCRA HAZARDOUS WASTE, LIQUID <br /> (USED OIL) . <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 221 ' <br /> TOTAL CONT i TYPE IT WT7VOL G SKOOT 11249 <br /> CNT#: 180407680781 SZ: BULK VOLUME CONTAINER QTY: 160 PROF# ISfiO17 CAS <br /> DESIGNATED FACILITY NAME/ADDRESS; <br /> SAFETY-KLEEN OF CALIFORNIA <br /> 6880 SMITH AVE, <br /> NEWARK CA 04560 <br /> TSD PHONE: 510-79S-4400 <br /> FACILITY USEPA IO NO CADDSOBS7418 <br /> FACILITY STATE IO NO <br /> If high risk source, rep, certifies that load specific PCO &Silicon <br /> testing have been completed prior to pumping this load. <br /> GENERATOR STATUS <br /> SQG/LQG: Vehicle <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 ofthe 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 (4) the <br /> General Terms and Conditions provided separately to Customer or (b) <br /> any SO 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 Costumer 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-Klmm's parts cleaner and paint gun cleaner services; Customer <br /> agrees that it will not introduce any substance into th,e 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 />