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Customer EPA N <br />Driver EPA #CAL 913534912 <br />CHP NCA88940 �,� 1 0 <br />J <br />Transporters Registration No: 3130 <br />Date: <br />State Manifest Document ti <br />SACRAMENTO WASTE OIL <br />4504 Dunnbury Way • Sacramento, CA 95842 <br />(916) 849-0144 <br />PAY FROM THIS INVOICE <br />INVOICE NO, <br />Next P/U Date: <br />CO. NAME PHONE ( ) <br />Term net 10 days. Finance charge of 2% per month (24% <br />ADDRESS <br />CITY STATE ZIP <br />per year) on accounts <br />CITY <br />DESCRIPTION <br />PRICE <br />TOTAL <br />will <br />Non-RCRA Hazardous Waste Liquid. Used oil/mixed oil. <br />/per <br />*No Placard required (221) <br />gal <br />Non-RCRA Hazardous Waste Liquid. Used anti -freeze. <br />/per <br />*No placard required (343) <br />gal <br />Non-RCRA Hazardous Waste Liquid. Used oil with water <br />/per <br />*No Placard required (221)>10% Water <br />gal <br />Non-RCRA Hazardous Waste Liquid: Oily water. <br />*No placard required (223) <br />I � <br />i <br />TOTAL m*� <br />DESTINATION OF ALL LIQUIDS ALT, <br />RES, W.O. Dixon W.O. Ceres <br />1515 S. River Road 7000 Chevron Way 1920 Morgan Rd <br />West Sacramento, CA 95691 Dixon, CA 95620 Ceres 95358 <br />CAD 044 003 556 CAT 080 012 602 CAL 000 393 680 <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 -stale 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, 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: 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 />of enforcement shall be in Sacramento County. I declare <br />Transporter's Signature: under perjury that the foregoing is true and correct. <br />per year) on accounts <br />not paid <br />within 30 days. <br />A $95.00 Fee <br />will <br />be charged for returned checks. <br />