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Customer EPA ft fes!-1 l 000 3 Date: �— ��—M <br /> Driver EPA#CAL 000375092 State Manifest Document If <br /> CHP#CA192005 CRYSTAL BLUE QI Lo% 26q 7'3 J!C <br /> ENVIRONMENTAL INVOICE NO. 0676 <br /> 2075 East Emilie Ave. Fresno CA, 93730 PAY FROM THIS INVOICE <br /> (310) 880-5820 <br /> Transporters Registration No:6104 Next P/tIJ Date: <br /> CO. NAME v z` PHONE ( (IU) <br /> ADDRESS 'O b <br /> CITY STAT ZIP <br /> QTY DESCRIPTION PRICE TOTAL <br /> Non-RCRA Hazardous Waste Liquid. Used oil/mixed oil.�U /per'No Placard required (221) gal <br /> Non-RCRA Hazardous Waste Liquid. Used anti-freeze. /per <br /> 'No placard required (343) gal <br /> SNon-RCRA Hazardous Waste Liquid. Oily water. /per <br /> 'No placard required (223) , ,�l/ gal <br /> f <br /> m <br /> V <br /> TOTAL -� o L) <br /> 'F-Al TH <br /> DESTINATI OF OIL Lir;,, --04 04 r KERN OIL <br /> S. <br /> 7515 South River Rd. 5300 Cloth Road <br /> Riverbank,CA 95367 <br /> Sacramento,CA CAD044003556 CAL000190816 <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL.PLEASE SIGN AFTER READING. <br /> Crystal Blue Environmental hereby advises the generator that your shipment of used oil may be transported to a facility that is required to comply with federal <br /> regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste man- <br /> agement facilities.California facilities that handle or process used oil are required to meet those more stringent requirements,and some out-of-state facilities <br /> that process used oil also meet those requirements.These Include more stringent leak detection and prevention requirements,engineering certifications of tank <br /> integrity,and financial 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 <br /> management standards and not these more stringent requirements. This notification is for information purposes only, <br /> GENERATORS CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name, <br /> are classified,packed,marked,labeled,and are in all respects in proper condition for transport by highway according to applicable state and federal regulations, <br /> If I am a large quantity 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 <br /> to be economically practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the <br /> present and future threat to human health and the environment;OR,if I am a small quantity generator,I have made a good faith effort to minimize my waste <br /> 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 <br /> any other hazardous waste,the total halide content is SS than 1,000 ppm,and the waste does not contain any PCBs.I have complied with the requirements <br /> of the applicable Califor4managemlatItodetermine sis e.1 agree to accept theadditional charges for the disposal of this waste if the <br /> information I have provi .I reby certify st all information submitted in this and all attached documents contains true and <br /> accurate description of the waste.All relevant information <br /> Generator's Signregarding known or suspected hazards associated with <br /> the waste has been disclosed.I also certify that I have not <br /> Contact Person: mixed this waste with any other waste,Venue for purposes <br /> Transporter's Sigof enforcement shall be in Sacramento County.I declare <br /> under perjury that the foregoing Is true and correct. <br /> Term net 10 days.Finance charge of 2%per month(24%per year)on accounts not paid within 30 days. <br /> A$25.00 Fee will be charged for returned checks. <br />