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Customer EPA # Driver EPA #CAL 913534912 Date: CHP #CA88940 State Manifest Document # 4 INVOICE NO. ATE OX 4504 Dunnbury Way • Sacramento, CA 95842 PAY FROM THIS INVOICE 10% l - 0144 Transporters Registration NO: 3130 Next P/U Date: CO , NAME PHONE ( l ADDRESS CITY STATE ZIP QTY DESCRIPTION PRICE TOTAL Non -RCRA Hazardous Waste Liquid . Used oil/mixed oil . /per *No Placard required ' (221 ) gal Non-RCRA Hazardous Waste Liquid , Used ,anti -freeze. /per *No placard required (343) gal Non-RCRA Hazardous Waste Liquid . Oily water. /per * No placard required (223) gal TVOTAL DESTINATION OF OIL ALT. ' o R. E.S. o DK Dixon o T. F. o R. 0. T. io 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 CAD 044 003 556 CAT 080 012 602 NAV 982 510 711 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 thatyourshipment of used oil may be transported to a facility that is required to comply with federal regula. tions applicable to management of used oil, but that is not required to comply with the more stringent requirements 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 consignment are fully and accurately described above by proper shipping name, are classified, packed, marked, labeled, and are 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 that l 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, selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a small quantity generator,' 1 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 does not contain any PCBs. I have complied with the requirements 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 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 FGenerator'sgnature: regarding known orsuspected hazards associated with n : the waste has been disclosed. I also certify that I have not mixed this waste with any other waste. Venue for purposes Signature: of enforcement shall be In Sacramento County. I declare under perjury that the foregoing is true and correct. Term net 10 days. Finance charge of 2% per month (24% per year) on accounts not paid within 30 days. A $25. 00 Fee will be charged for returnedchecks.