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77 Driver. /j -.. 4912 Dated ( CHP#CA88940 State Manifest Document# (- � SACRAMENTO WASTE OIL INVOICE NO. 1069 4504 Dunnbury Way • Sacramento, CA 95842 PAY FROM THIS INVOICI Transporte istratio0 (916) 849-0144 Next P/U Date: CO. NAME -'C ADDRESS PHONE ATE OTY ZIP Q DESCRIPTION I i Non-RCRA Hazardous Waste Liquid. Used oil/mixed oil. PRICE TOTAL No Placard required (221) /per I gal Non-RCRA Hazardous Waste Liquid. Used anti-freeze. 'No placard required (343) /per gal Non-RCRA Hazardous Waste Liquid. Oily water. 'No placard required (223) /per gal i i TOTAL DESTINATION OF OIL ��. TI ALTERNATIVES I 1515 S.River Road ❑DK Dixon ❑Thermo Fluids West Sacramento,CA 95691 7000 Chevron Way 655 South Stanford Way CAD 044003556 Dixon,CA 95620 Sparks,NV 98431 CAT080012602 NAV 982 510 711 Sacramento f( IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL.PLEASE SIGN AFTER READING. Waste Oil hereby advises the generator that your shipment of used oil may be transported to a facility that is required to comply with federal regula. i tions applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management used oil also meet those requirements.Th rocess used oil are required to meet those more stringent requirements,and some out-Of-state facilities that process facilities.California facilities that handle or p f ese include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and tfinancial assurances for closure and accidental releases. It is lawful to send used oil to Out-Of-state facilities that comply only with federal used oil management standards and not these more stringent requirements. This notification is forinformation purposes only. I GENERATORS CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping are classified,packed,marked,labeled,and are in all respects in proper condition for transport by highway according to.applicable state and federal regulations. y If I am a large quantity caping name, t ty generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have.determined to be economically practicable and that I have selected the practicable method of treatment storage, I have made a good faith effort to minimize my waste storage,or disposal currently available to me which minimizes the q Present and future threat to human health and the environment;OR,if Lam a small- uantity i generated and select the best waste management method that is available to me and that I can afford. I have not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than 1,000 Ppm,and the waste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulations to determine this is true.I agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect.I hereby certify that all the information submitted in this and all attached documents contains true and I Generator's Signature: . % . '� _ — accurate description of the waste.All relevant information - Contact Person: regarding known or suspected hazards associated with the waste hasbeen disclosed.I also certify that I have not Transporter's Signature:— I I ` ' mixed this waste with any other waste.Venue for purposes of enforcement shall be in Sacramento County.Ideclare Term net 10-0 davsFinanrc..i,.,.,... under perjury that the foregoing is true and correct. . _�..^,