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CSG SH-SSL-BOX-23 Raymond Gome: 11/19/18 15:17 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NSR. <br /> CUSTONERO/GENERATOR: LK06044 Lkq 78339652-1$05514251 <br /> 2041 Navy Dr <br /> Attn Jerry <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 <br /> GENERATOR USEPA ID. CAL000268997 GENERATOR STATE 9060019999 <br /> MANIFESTO: 006687261SKS FORM CD: ID SHIP$ 226655477 <br /> TRANSPORTER I TXR000081205 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, LIQUID <br /> (AQUEOUS PARTS WASHER SOLUTION) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 134 <br /> TOTAL CONT 1 TYPE DM WTIVOL G SKDOT 14441 <br /> CNTO: 181027590039 S2: 30 GAL/114 L CONTAINERS QTY: 20 PROFO 156023 CA CAT CODE-G <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 6000 88TH STREET <br /> SACRAMENTO CA 95528 <br /> TSD PHONE: 916-786-9913 <br /> FACILITY USEPA Id NO CADOOOO84517 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 0-2240 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 (11 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 (21 incorporated <br /> herein by reference. Sinless otherwise indicated in the payment <br /> received section, SK is auth0r12ed. 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 (l8% per annum) or <br /> (ill 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 SPA 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 partslpaint 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 />