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Customer EPA# ( . do -../ Date: �3 Driver EPA#CAL 9135349191 2 CHP#C State M est Doc e C A E T S E IL IN OICE o. 1 63 45 4 Du nbu Wa • S cram Mo. A 9 842 PA FR M THO INV ICE Trans rters R ( 16) 84 -0 44 P gistraton No: 3130 ext P/ Date, CO. ADD ESS CITY STA Z O DE CRI ION RICE T TAL 'No lacard requir d ( 1) per gal Non- CRA azar ous aste Lquid. sed ril eze. /per No lacard requir d ( 3) gal Non- CRA azar ous aste quid. ily w ter. o acar requir /per ga c'd t 201 TO AL n DSTIN TION OF OI R.E.S. DK Di on o Ther o Flui s /�jverb nk Oil ransfe 9 1515 .River load70 0 Chevr n Way 6 5 South tanford Way 530 Claus d. m W st Sacr mento, A 9569 Di on,CA 5620 Sparks,NV 984 1 Riverb nk,CA 9 367 at CAD 44 003 556 C 0800 2 602 NAV 98 51071 CAL 00190 16 m a POR ANT N TICE F =GAR[ING TH=DISK SITION OF YO RUSE OIL. EASE IGN A TER R ADING tacram nto WE Ste Oil reby So vises 0-a gener ter that our shi ment c used of may b transp ed to facility i at is re uired tc comply ith fed ral regula- tions af plicable to mans gement f used il,but tt at is no require to Comply with he mor, stringe it requir ments ipplicab a to hoz rdous t oaste m nagement facilitie .Califor iia facili es that iandle r proce used c i1 are re uire l tc meet&ose Mel a string nt requi ements and set is out-o-state f cilities t iat process used of also m at those requirei ients.T iese in ude mo a string ant leak Jetectio i and pr ventton require ients,a igineerh ig o.rtifi tions f tank it tagrity,and financie I assure ices for losure nd acci Jental r leases. t is lawl it to senJ used it to out f-state acilities that cor ply onl with fac eral USE oil ma iagement standaf Js and r ot these more at ingent r quirem nts. Th s notific ition is r intorn ation pL poses my. GENEF ATORS CERTIF ICATIO :1 her y decd a that tl iso contE its of th s consi nment Ere fully z nd aCCL ately d scribed above bro proper shi p p aname, are cls sifed, packed, arked,I baled, nd are i all respects in roper c ndition or transort by ighway ccordi g to ap l!cable ate and federal eoulations. If I am large q jantity ganeratoi I certi that I h ve a pr gram in place tc reduce he voou ne and oxicity C I waste enerat d to the degree have d itermined to be a onomici illy prat lcable a id that I have se acted th a practi able his hod of eatmen t,storag a,or dis osal cu rently a eaflable o me WI iich min mizes the presen and fUtL re three to hum n healtl i and th enviro menta C R,if I at i a sma quant' generE ter, I haa made a good aith ea genera d and elect th best w ste ma ageme t metho that is vailabl to me nd that can off rd.I he a not m x d an of the aste described ovetwith any oth r hazer JOUS WE As,the Dtal hall le cont t is LE S than 1,000 or m,a he wast does r Dt conta n any P Bs.I h ive com Med wit 1 the rei uirements of thea plicabl Califor is used Dil manit gement regulati ns to do termine this is t e to ac apt the addition 1 charg s for th dispos I of this waste if the inform ion a ha provi ed abo t this w ste Nin orrect. hereby ify t at all th to su mitted il i this anI all alta had documents contain true and occur, to desc iption o the wase.All re event i ormation G nerato 's Sign tura: regarc ing kno n or su petted iazards associa ed with C4 intact P 3rsom thew Ste has been di closed. also c ify that I have not mixed this wat to with ny othe waste. /enue f r purposes Tr insport is Sig ature: o en rcemen s a m ac mun o oun y. declare under perjury I iat the regoin is true nd Corr ct. Term net 10 1 lays. Fir ante charge of %per i ionth( %per ear)on accourol s not pd within 30 day . A J25.00 ee will I a charg ad for returned ciliecks.