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Customer EPA# Date: Driver EPA#CAL 000375092 State Manifest Document# CHP#CA192005 CRYSTAL BLUE INVOICE NO. 1797 MENTAL � 7Ss � s�_ ENVIRON 2075 East Emilie Ave. Fresno CA, 93730 PAY FROM THIS INVOICE (310) 880-5820 Transporters Registration No: 6104 Next P/Ll Date: f.z rg CO. NAME PHONE ADDRESS CITY STATE ZIP QTY DESCRIPTION PRICE TOTAL Non-RCRA Hazards s Waste Liquid. Used oil/mixed oil. / 'No Placard require (221) ' �, gal �.., Non-RCRA Hazardo is Waste Liquid. Used anti-freeze. /per `No placard require (343) gal Non-RCRA Hazardo is Waste Liquid. Oily water. /per `No placard require (223) gal ENVIRONM 11HLHFALTfi w _ F+T• RV�CFS TOTAL --� DESTIN TION OF OIL World Oil -San Joaquin o E.S. 14287 East Manning Ave. 1515S uth River Rd. Parlier, CA 93648 Sa ramento, A CAD044003556 IMPORTANT NOTICE REGARDING THE ISPOSITION OF YOUR USED OIL.PLEASE SIGN AFTER READING. Crystal Blue Environmental hereby advises he generator that your shipment of used oil may be transported to a facility that is required to comply with federal regulations applicable to management of us d oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste man- agement facilities.California facilities that hIn' le 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 requiments.These include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and financial assurances for closuand accidental releases. It is lawful to send used oil to out facilities that comply only with federal used oil management standards and not these mortringent requirements. This notification is for information purposes only. GENERATORS CERTIFICATION:I herebyclare that the contents of this consignment are fully and accurately described above by proper shipping name, are classified, packed,marked,labeled,anre 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 thI 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 haselected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health athe 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 manag ment 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 ontent 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 01 manage ent 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. Termet 10 day . Finance charge of 2%per month(24%per year)on accounts not paid within 30 days. A$25.00 Fee will be charged for returned checks.