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BRANCH SSL CSG PW-24 _.1 ,.izA..r. OBJO3/15 12:47 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NSR. <br /> CUSTOMER#/GENERATOR: LKO0044 Lkq 67541299 <br /> 2041 Navy Dr <br /> Attn Jerry SRVC DATE: 08/03/15 <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 CONTACT NAME: Lkq <br /> GENERATOR USEPA ID. CA1000268997 GENERATOR STATE 9064019999 <br /> MANIFEST#: 00502825gsks FORM Co: to SHIP# 216623712 <br /> TRANSPORTER 1 TXR00O081205 SAFETY-KLEEN SYSTEMS, INC. <br /> 5050 SALIM BLVD <br /> SALIDA,CA. 95368 <br /> TNSP PHONE: 209-545-1Dll <br /> TRANSPORTER 2 <br /> US DOT DESCRIPTION 11NCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND LD1 <br /> NON-RCRA HAZARDOUS WASTE, LIQUID <br /> (AQUEOUS PARTS WASHER SOLUTION) <br /> FEDERAL WASTE CODES NONE <br /> STATE wAS7E CODES 134 <br /> TOTAL CONT 1 TYPE DM WTIVOL G SKDOT 14941 <br /> CNT#: 150713946056 S2: 30 GAL/SL4 L CONTAINERS QTY: 20 PROF# 156023 CA CAT CODE:G <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLE£N SYSTEMS, INC. <br /> 6000 BOTH STREET <br /> SACRAbENTO CA 95828 <br /> TSD PHONE; 916-386-4913 <br /> FACILITY USEPA ID NO CA00O0084517 <br /> FACILITY STATE ID NO <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Customer certifies that (t) 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 (ii) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the wastelmaterial_ Customer agrees to pay the above <br /> charges and to be hound by the terms and conditions (11 set forth in <br /> (a) the General Terms and Conditions provided separately to Customer <br /> or 4b} any Sit agreement signed by Customer and SK, and (2) <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. Satety-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 /> trifluratrichloroethane dry cleaning solvents. Customer agrees that it <br /> is responsible for properly classifying its waste streams as Used Oil <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 Ron-conforming substance into the SK Property, <br />