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12/ 19/ 2019 45 : 16PM 12095250041 SACRAMENTO WASTE CIL PAGE 01 / 01 Customer EPA # feo 6 Date: .3�' Driver EPA #CAL 913534912 State Manifest Document # CNP # CAS8940 l /� fCJtt�dD . i >l � C � � • � �'�/� INVOICE NO . 4 2 8 3 0 SACRAMENTO WASTE OIL 4504 Dunnbury Way ® $acrarnento , CA 95842 PAY FROM TEAS INVOICE (916) 849loOl 44 Transporters Registration No ' 313n Next P/U Date: CO . NAME /t �c C' }irt, PHONE _) �j � 7J ,1 ADDRESSi1 L5 b Ci i1' Ciu STATE LdL� ZIP 41 AS OT+ DESCRIPTION PRICE TOTAL NonuRCRA Hazardous Waste Liquid . Used oil/mixed oil . /per * No Placard required (221 ) gal Non - RCRA Hazardous Waste Liquid . Used an#i4reeze. /per * No placard required (343) gal c Nor; - RGRA Hazardovs Waste Liquid . 0 ate r. /per G wNo placard required (22 $) , gal TOTAL - .. DESTINATION OF OIL. AL'T' R . E.S. DK Dixon T. F. A , 0 , T , S • K• 1515 S. River Road 7000 Chevron Way 655 South Stanford Way 5300 Claus Rd . 6880 Smith Ave, West Sacramento , CA 95691 Dixon, CA 95620 Sparks, NV 98431 Riverbank, CA 95367 Newark, CA 94560 CAO 044 003 556 CAT 080 012 602 NAV 952 510 711 CAL 000190 816 CAD 980 887 418 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 on, but that is not required to comply with the more stringent rsqulrements 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 oonaignment are fully and accurately described above by proper shipping name, are classified , packed, marked , labeled , and are In an 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 I have aelectea the practicable method of treatment , storage, or disposal currently avallable 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 doss not contain any PCBs. I have complied with the requirements of the applicable California used oil management regulations to Atermina this is true. I agree to accept the addittonal charges for the disposal of this waste if the Information I have provided about this wto • incorre eflify 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: —Ziffregarding known or suspected hazards associated with the waste has been disclosed . I also certify that I have not Contact Person : '6�thIs waste with,,any ogler waste. Venue for purposes of enforcement shell be in S2ctarnento Co�rnty, I declare Transporter's Signature : u perjury that the foregoing is true and cc� rreot. "term net 10 days. Finance charge of 24/o per month (24% per year) on accounts not paid 7Jtiti 31011 ho 19 A $25,00 Fera will be charged for returned checks . ENViRONMiENii1i_