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Customer EPA --1`--�.d y D /j <br /> Driver EPA#CAL 000375092 �� Date: G ![ <br /> State Manifest Document# <br /> CHP#CA792005 CRYSTAL BLUE 1n 3 <br /> ENVIRONMENTAL INVOICE NO. 0 0 17 <br /> 4529 Baron Avenue • Sacramento, CA 95821 <br /> a. (310) 880-5820 PAY FROM THIS INVOICE <br /> - � <br /> Transporters Registration No:6104 <br /> Next P/U Date: <br /> CO. NAME r 3 �. gPHONE <br /> ADDR�E-StS� 1..� <br /> CITY '4L�C �\` � STATE ZIP <br /> CITY DESCRIPTION PRICE TOTAL <br /> CP Non-RCRA Hazardous Waste Liquid. Used oil/mixed oil. /per <br /> "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. r <br /> "No placard required (223) <br /> JED <br /> NOV 13 2014 <br /> TOTAL --)0- <br /> DESTINATION OF OIL ALTERNATIVES <br /> BANGO OIL 'i R.E.S. o DK Dixon o Thermo Fluids <br /> 22211 Bango Road 1515 S.River Road 7000 Chevron Way 655 South Stanford Way <br /> Fallon,NV West Sacramento,CA 95691 Dixon,CA 95620 Sparks,NV 98431 <br /> NV 000080655 CAD 044003556 CAT080012602 NAV 982 510 711 <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 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 m 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 1 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 I, Q-ppm,and the waste does not contain any PCBs. I have complied with the requirements <br /> of the applicable California used oil management regul� o a to dete e ft,is is true.I agree to accept the additional charges for the disposal of this waste if the <br /> information I have provided abou is waste is incorrect. l ereby certify t e 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 Signa re: under perjury that the foregoing is true and correct. <br /> Term net 10 days.Finance char a 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 />