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Customer EPA# _ Date: <br /> Driver EPA#CAL 913534912 04 ) <br /> State Manifest Document#CHP#CA88940 \\ INVOICE NO. - - <br /> SACRAMENTO WASTE OIL <br /> 4504 Dunnbury Way • Sacramento, CA 95842 PAY FROM THIS INVOICE <br /> (916) 849-0144 <br /> Transporters Registration No:3130 Next P/U Date: <br /> CO. NAME PHONE (_ ) <br /> ADDRESS <br /> CITY STATE ZIP <br /> CITY DESCRIPTION PRICE TOTAL <br /> Non-RCRA Hazardous Waste Liquid. Used oil/mixed oil. /per <br /> *No Placard required (221) gal <br /> Non-RCRA Hazardous Waste Liquid. Used anti-freeze. /per <br /> gat <br /> *No placard required (343) ' t <br /> Non-RCRA Hazardous Waste Liquid. Oily water. /per <br /> *No placard required (223) gali 'd' <br /> I <br /> t I , <br /> >, <br /> TOTAL -� <br /> DESTINATION OF OIL <br /> o R.E.S. o DK Dixon n Thermo Fluids o Riverhank Oil Transfer <br /> 1515 S.River Road 7000 Chevron Way 655 South Stanford Way 5300 Claus Rd. <br /> West Sacramento,CA 95691 Dixon,CA 95620 Sparks,NV 98431 Riverbank,CA 95367 <br /> CAD 044 003 556 CAT 080 012 602 NAV 982 510 711 CAL 000 190 816 <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL.PLEASE SIGN AFTER READING. <br /> 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- <br /> tions applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management <br /> facilities.California facilities that handle or process used oil are required to meet those more stringent requirements,and some out-of-stale facilities that process <br /> used oil also meet those requirements.These include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and <br /> 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 <br /> 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 LESS than 1,000 ppm,and the waste does not contain any PCBs.I have complied with the requirements <br /> 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 <br /> 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 <br /> accurate description of the waste.All relevant information <br /> r - regarding known or suspected hazards associated with <br /> Generator's Signature: !..- the waste has been disclosed.I also certify that I have not <br /> Contact Person: <br /> mixed this waste with any other waste.Venue for purposes <br /> of enforcement shall be in Sacramento County.I declare <br /> Trensporter's Signature: <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 />