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Customer EPA ifr 1 0 Date: <br /> Driver EPA#CAL 03750 2 �(..� / State Manifest Doc ment <br /> CHP#CA192005 CRYSTAL BLUE -��?L?��`K�r��`yK--- <br /> ENVIRONMENTAL INVOICE NO. 0154 <br /> P.O. Box 928162, San Diego 92192 <br /> (310) 8805820 PAY FROM THIS INVOICE <br /> Transporters Registration No:6104 Next P/U Date: <br /> CO. NAME C <br /> PHONE ( — <br /> ADDRESS a <br /> CITY STATE ZIP ___ <br /> OTY DESCRIPTION PRICE TOTAL <br /> Non-RCRA Hazardous Waste Liquid. Used Oil/mixed oil. /per`No Placard required (221) gal <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 /> R <br /> ffi <br /> m <br /> NOV 1 .1 2nI4 <br /> ENV TOTAL - 311- <br /> DESTINATION OF OIL KERN OIL <br /> R.E.S. 5300 Cloth Road <br /> 1515 South River Rd. Riverbank,CA 95367 <br /> Sacramento,CA CAD044003556 CAL000190816 <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 requirementsapplicable 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 for iniormafion 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 1 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 ma agement regulations to de ermine this is true.I agree to accept the additional charges for the disposal of this waste if the <br /> information I have provided abo t this ate is incorrect.t�feby W-ftiSthalall, h nfbrmation 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 />