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BRANCH SSL CSG 24 Anthony Romero 02/17/15 12:11 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR. <br /> CUSTOMER#/GENERATOR; LE00044 Lkq 66034834 <br /> 2041 Navy Dr <br /> Attn Jerry SRVC DATE; 02/17/15 <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 CONTACT NAME: Lkq <br /> GENERATOR USEPA ID. CAL0002E8997 GENERATOR STATE 9460019999 <br /> MANIFEST#; 004696612SKS FORM CD: 1D SK SHIP# 215261248 <br /> TRANSPORTER 1 T%R000081205 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 SOLTJTIONI <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 134 <br /> TOTAL CONT 1 TYPE OR WTIVOL G SKDOT 14941 <br /> CNT#; 150125936290 S2; 30 GAL/114 L CONTAINERS QTY: 25 PROF# 156023 CA CAT CODE;G <br /> DESIGNATED FACILITY NAME/ADDRESS; <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 6000 88TH STREET <br /> SACRAMENTO CA 95828 <br /> TSD PHONE: 916-386-4913 <br /> FACILITY USEPA ID NO CA0000084517 <br /> FACILITY STATE IA NO <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Customer certifies that €f1 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 and €iif no material change has occurred <br /> either in the characteristics of the wastelmaterial or in the process <br /> generating the waste/material. Customer agrees to pay the above <br /> charges and to be bound by the terms and conditions ill set forth in <br /> (a) the General Terms and Conditions provided separately to Customer <br /> or (h) any SK agreement signed by Customer and SK, and )21 <br /> incorporated herein by reference. Unless otherwise indicated in the <br /> payment received section, SK is authorized to charge Customer's <br /> account for this transaction. Customer certifies that the individual <br /> signing this Service Acknowledgement is duly authorized to sign and <br /> bind Customer. The following provision is applicable to Safety-Kleen's <br /> parts cleaner and paint gun cleaner services: Customer agrees that It <br /> will not introduce any substance into the solvent or aqueous cleaning <br /> solution, Including without limitation any hazardous waste or <br /> hazardous waste constituent, except to the extent such introduction is <br /> incidental to the normal use of the machine. Customer Further agrees <br /> that it will not clean parts/paint guns that have been contaminated <br /> with or otherwise introduce polychlorinated biphenyls {PCB's}, <br /> herbicides, pesticides, dioxins or listed hazardous waste into the <br /> solvent or aqueous cleaning solution. Safety-Kleen has the capacity <br /> and Is permitted to accept, store, and/or reclaim the spent parts <br /> 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 /> triflurotrichloraethane dry cleaning solvents. Customer agrees that it <br /> is responsible for properly classifying its waste streams as Used ail <br /> or Nonhazardous Waste in accordance with the provision of 40 CFR <br /> 262.11 and applicable state laws. Customer agrees that it will not <br /> introduce any nen-conforming substance into the SK property, <br />