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[3amos Environmental Services <br /> V1515 South River Rd . <br /> /AECE West Sacramento , CA 95691 <br /> AUG 2 7 2021 (916) 371 -5747 <br /> CAD044003556 <br /> ENVIRONMENTAL HEALTH . SERVICE <br /> pFPARTMENT SERVICE ORDER ORDER No. 170380 <br /> BILL OF LADING <br /> DATE JOB NUMBER " <br /> GENERATOR o7�.� � {-� — ' t r GENERATOR EPA # <br /> BILLING ADDRESS <br /> AMOUNT (IF ANY) . 4 <br /> GENERATOR CONTACT CHECK NUMBER <br /> PHONE P. O . NUMBER <br /> JOB SITE ADDRESS CASH RECEIVED (amt.) <br /> ) 2 n <br /> HALIDES 6Q7 L `' P. P. M . <br /> JOB DESCRIPTION �y �' <br /> `:JAS <br /> C L <br /> MATERIALS <br /> J(LNON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE # START TIME ® s JJ <br /> ARRIVE TIME t? t <br /> r] NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE # LEAVE JOB 6 . l <;f <br /> F] U . S. DOT DESCRIPTION : STOP TIME C <br /> (USED ANTI -FREEZE) NON RCRA HAZARDOUS WASTE LIQUID CODE # USED OIL FILTERS DRUMS <br /> MANIFEST NO. vix I J J NO. OF GALLONS <br /> DRIVER ' S SIGNA TRUCK # <br /> DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES. 1515 SOUTH RIVER RD. WEST SACRAMENTO 95691 CAD 044003556 <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY OTHER WASTE, AND THE TOTAL HALIDES ARE LESS THAN 1000 P. P. M . <br /> This is to certify that the above named articles are properly classified , described, packaged , marked and are in proper condition for <br /> transportation , according to the applicable regulations of the Department of Transportation . <br /> Generator's Certification : I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practicable. Ramos agrees with the generator to send all their hazardous waste to an authorized hazardous waste treatment facility <br /> via Ramos' standardized permitted storage facility. <br /> All used oil collected from the generator listed above will be transported only to a facility permitted by the State of California to accept used oil. <br /> Terms - net 15 days. <br /> After due date, a finance charge of 1 .50% per month, 18.00% annual rate, will be charged on the unpaid balance. The customer agrees to pay reasonable <br /> costs and attorney fees incurred in the collection of this obligation . Venue for purposes of enforcement of this obligation shall be Yolo County. <br /> I declare, under penalty of perjury that the foregoing is true and correct. <br /> X 5\7 <br /> ERATOR SIGNATURE <br /> 24 Hour Emergency Response Team : 1 - 800 - 456 - 7745 "II ul <br />