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CSG SK-SSL-UMO- 01 Joseph R Lima Jr 05 / 04 / 17 10 : 05 PAGE 2 <br /> SHIPPING DOCUMENT <br /> REFERENCE NBR , <br /> CUSTOMER # / GENERATOR : G011213 Gordon Trucking Inc 73613509 <br /> 12550 S Harlan Rd <br /> Lathrop CA 95330 - 8744 <br /> PHONE 209- 640 - 0555 CONTACT NAME : Gordon Trucking Inc <br /> GENERATOR USEPA ID . CAL00033498S GENERATOR STATE 9060019999 <br /> MANIFEST # : 005947924SKS FORM CD : 1D SHIP # 222312131 <br /> TRANSPORTER 1 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 /> ( USED OIL ) <br /> FEDERAL WASTE CODES NONE <br /> STATE WASTE CODES 221 <br /> TOTAL CONT 1 TYPE TT WT /VOL G SKDOT 11249 <br /> CNT # : 170504875533 SZ : BULK VOLUME CONTAINER QTY : 480 PROF# 156017 CA CAT CODE : A <br /> DESIGNATED FACILITY NAME /ADDRESS : <br /> SAFETY -KLEEN OF CALIFORNIA <br /> 6880 SMITH AVE . <br /> NET47ARK CA 94560 <br /> TSD PHONE : 510 - 795 - 4400 <br /> FACILITY USEPA ID NO CAD980887418 <br /> FACILITY STATE ID NO <br /> If high risk source , rep . certifies that load specific PCB & Silicon <br /> testing have been completed prior to pumping this load . <br /> GENERATOR STATUS <br /> CESQG : 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 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 ( 1 ) 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 ( 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 Customer 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-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 parts / paint 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-K1een 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 />