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40 Customer EPA # Date: Driver EPA #CAL 913534912 State Manifest Document # CHP # CA88940 C 0 D SACRAMENTO WASTE OIL PAY FROM THIS INVOICE 4504 Dunnbury Way • Sacramento , CA 95842 INVOICE NO. . (916) 849 = 0144 4 � x Transporters Registration No: 3130 Next P/U Date: CO. NAME PHONE ( ) ADDRESS CITY STATE ZIP OTY DESCRIPTION PRICE TOTAL Non - RCRA Hazardous Waste Liquid . Used oil/mixed oil . /per � . ; No Placard required (221 ) gal Non- RCRA Hazardous Waste Liquid . Used anti-freeze . /per ' No placard required (343) gal Non - RCRA Hazardous Waste Liquid. Used oil with water /per `No Placard required (221 ) > 1C % Water gal Non - RCRA Hazardous Waste Liquid . Oily water. Kr. r. IVL; LJ ' No placard required (223) WOMEN ENVIRO MENTAL HEALTH PER! 11MERVICES TOTAL -� DESTINATION OF ALL LIQUIDS ALT. R . E. S . W.O. Dixon W.O. Ceres 1515 S. River Road 7000 Chevron Way 1920 Morgan Rd West Sacramento , CA 95691 Dixon , CA 95620 Ceres 95358 CAD 044 003 556 CAT 080 012 602 CAL 000 393 680 IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL . PLEASE SIGN AFTER READING . Sacramento 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- tions applicable to management of used oil , but that is not required to comply with the more stringent requirements applicable to hazardous waste management facilities . California facilities that handle or process used oil are required to meet those more stringent requirements , and some out-of-state facilities that process used oil also meet those requirements . These include more stringent leak detection and prevention requirements, engineering certifications of tank 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 management standards and not these more stringent requirements . This notification is for information purposes only. GENERATORS CERTIFICATION : I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name , are classified , packed , marked , labeled , and are in all respects in proper condition for transport by highway according to applicable state and federal regulations . 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 to be economically practicable and that 1 have selected the practicable method of treatment, storage , or disposal currently available to me which minimizes the 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 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 accurate description of the waste. All relevant information Generator's Signature : regarding known or suspected hazards associated with the waste has been disclosed . I also certify that I have not Contact Person : mixed this waste with any other waste. Venue for purposes of enforcement shall be in Sacramento County. I declare Transporter 's Signature : under perjury that the foregoing is true and correct . Term net 10 days. Finance charge of 2% per month (24% per year) on accounts not paid within 30 days. A $ 45 . 00 Fee will be charged for returned checks .