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CSG SK-SSL-BOX-23 David L Buxton 01/20/16 13:35 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR. <br /> CUSTOMERNIGENERATOR: LK00044 Lkq 691 06 965 <br /> 2041 Navy Dr <br /> Atta Jerry SRVC DATE: 01/20/16 <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 CONTACT NAME: Lkq <br /> GENERATOR USEPA ID. CAL000268997 GENERATOR STATE 4060014999 <br /> MANIFESTM: 005244522aks FORM CB: 1D SHIPN 2180603$i <br /> TRANSPORTER I TXRO00081205 SAFETY-XLEEN SYSTEMS, INC. <br /> 5050 SALIDA BLVD <br /> SALIDA,CA. 95368 <br /> TN5P PHONE: 209-545-1011 <br /> TRANSPORTER 2 <br /> US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND Ila) <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 DN WT/VOL G SKDOT 14941 <br /> CHT*- 151226046434 SZ: 30 GAL/114 L CONTAINERS OTY: 20 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 ID NO <br /> GENERATOR STATUS <br /> 0-220 lbs/manth <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 and (ii) no material change has occurred <br /> either in the characteristics of the waste/material 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 (1) set forth in <br /> (a) the General Terms and Conditions provided separately to Customer <br /> or (b) any SK agreement signed by Customer and SX, 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. If Customer fails to make payment when <br /> due, an amount equal to the lesser of (i; 1.56 per month (189 per <br /> annum} or (ii] the maximum amount allowed by law, will be added to all <br /> unpaid amounts outstanding. 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 /> trifiurotrichloroethane dry cleaning solvents. Customer agrees that it <br /> is responsible for properly classifying its waste streams as Used Oil <br />