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Customer EPA# <br /> Date: <br /> "Driver EPA#CAL 000427848 State Manifest Document# <br /> CHP#CAI 92005 2 <br /> CRYSTAL BLUE 1 <br /> ENVIRONMENTAL INVOICE NO. 050 <br /> 7337 Herlong Way Sacramento, CA 95660 <br /> (n♦5) 996-3350 PAY FROM THIS INVOICE <br /> Transporters Registration No:6104 V Next PIU Date: <br /> CO. NAME PHONE <br /> ADDRESS <br /> CITY STATE Zip <br /> QTY DESCRIPTION PRICE TOTAL <br /> Nan-RCRA Hazardous Waste Liquid. Used oil/mixed oil_ <br /> er <br /> *No Placard required (221) 'gal 170 <br /> Non-MCRA Hazardous Waste Liquid. Used anti-freeze. /per <br /> "No placard required (343) gal <br /> Non-RCRA Hazardous Waste Liquid. Oily water. /per <br /> *No placard required (223) gal <br /> TOTAL --0- <br /> DESTINATION OF OIL ALTERNATIVES <br /> Ramos Environmental -1 Asbury Environmental <br /> 1616 5.RiverRoad 14287 E. Manning Ave. <br /> West Sacramento,CA 95691 Parlier,CA 93648 <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"otification is for information purposes only- <br /> GENERATORS <br /> nlyGENERATORS CERTIFICATION:I hereby decinre that the contents of this consignment are fully and accurateiy 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 1 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 /> Generator's Signature: regarding known or suspected hazards associated with <br /> .; the waste has been disclosed.I also certify that I have not <br /> Contact Person: the <br /> this waste with any other waste.Venue for purposes <br /> Transporter <br /> 's'S Signature: of enforcement shall be in Sacramento County.I declare <br /> under perjury that the foregoing is true and correct. <br /> 3 r_- f P l Y g 9' <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 />