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Customer EPA # ; <br /> Date: , <br /> Driver EPA #CAL 913534912 State Manifest Document # <br /> CHP #CA88940 <br /> C4*D I've, <br /> INVOICE NO. <br /> SACRAMENTO WASTE OIL <br /> 4504 Dunnbury Way ® Sacramento, `CA 95842 PAY FROM THIS INVOICE <br /> t916) <br /> Transporters Registration No: 3130 Next P/Ll Date: <br /> CO. NAME PHONE C. <br /> ADDRESS <br /> CITY STATE <br /> ZIP <br /> QTY DESCRIPTION PRICE TOTAL <br /> - T T111T Non -RCRA Hazardous Waste Liquid . Used oil/mixed oil. /per <br /> * No Placard required (221 ) gal <br /> below <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 /> TTL <br /> DESTINATION OF OIL ALT. <br /> o R.E.S. o DK Dixon o T. Fe o Re Do T. o S , K. <br /> 1515 S. River Road 7000 Chevron Way 655 South Stanford Way 5300 Claus Rd. 6880 Smith Ave, <br /> West Sacramento, CA 95691 Dixon, CA 95620 Sparks, NV 98431 Riverbank, CA 95367 Newark, CA 94560 <br /> CAD 044 003 556 CAT 080 012 602 NAV 982 510 711 CAL 000190 816 - CAD 980 887 418 <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-state 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, it 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, 1h 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: mixed this waste with any other waste. Venue for purposes <br /> Transporter's Signature: 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 />