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Customer EPA #1 i ` . � � � � ��1� �t�� Date: <br /> Driver EPA #CAL 000427808 State Manifest Document # <br /> CHP #CA192005N NL <br /> CRYSTAL BLUE INVOICE NO. 1059 <br /> ENVIRONMENTAL <br /> 7337 Herlong Way North Highlands , CA 95660 <br /> �� �._... . 415 996-3350 PAY FR ® M THIS INVOICE <br /> Transporters Registration No : 6104 Next P/U Date: <br /> CO . NAME s % 40 � !' �. r 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 /> * No placard required (343) gal <br /> Non - RCRA Hazardous Waste Liquid . Oily water. /per <br /> * No placard required (223) gal <br /> 55 Gallon Drum filled with Used & drained oil & gas filters . /per MAR 20 2019 <br /> drum <br /> I-% ;= ,111. . 1 IA DIEF)ARTMI <br /> TOTAL <br /> ❑ DESTINATION OF OIL ❑ ALTERNATIVES ❑ DESTINATION OF FILTERS <br /> RES AES <br /> 1616 S . River Road 14287 E . Manning Ave . 401 W. Channel Road <br /> West Sacramento , CA 95691 Parlier, CA 93648 Benicia , CA 94510 <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 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 /> Generator's Signature: `f i regarding 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 Signature : S ( rr' a of 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 />