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Customer EPA # ,'7/ • „ + Date: <br />Driver EPA #CAL 000375092 State Manifest Do ment # <br />CHP #CA192005 <br />[IECEIVEC CRYSTAL BLUE <br />ENVIRONMENTAL INVOICE No. 1372 <br />MAR 0 6 2075 East Emilie Ave. Fresno CA, 93730 <br />PAY FROM THIS INVOICE <br />F-WRONMENTA; (310) 880-5820 <br />Transporters Registration No: 6104 Next P/U Date: <br />CO. NAME i1 w' I I i PHONE ( ) 02 6.6 <br />ADDRESS <br />CITY LIP <br />CITY <br />DESCRIPTION <br />PRICE <br />TOTAL <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. Oily water. <br />'No <br />(f /per <br />+ <br />placard required (223) <br />,j3 , gal <br />TOTAL --0- <br />DESTINATION OF OIL World Oil - San Joaquin <br />H.E.S. 14287 East Manning Ave. <br />1515 South River Rd. Parlier, CA 93648 <br />Sacramento, CA CAD044003556 <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 forinformation 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 gontain 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• hisy✓aste. is incorrect. 1 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 />-.,,f4, -• <br />Signature: .� i regarding known or suspected hazards associated with <br />the waste has been disclosed. I also certify that I have not <br />EGen <br />son: ? mixed this waste with any other waste. Venue for purposes <br />} of enforcement shall be in Sacramento County. I declare <br />'s Signature: ,� 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 />