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Send Payment to: Invoice No. <br /> Aflaxir� i til Service 50 9 9 Z <br /> 61,E . gate d ��u <br /> PO� ft 383 <br /> SIL SERVIGE Loomis; ca.s5s5o Arrival <br /> 1.888-609.2629 <br /> G Ne Bill to <br /> Adqress Address <br /> E `� �` til <br /> R City/ Z) to ZipCity State Zip <br /> T Phone Fax Phone <br /> O (y1-GLfi 1 <br /> R Customer EPA#(-,4 .. , I Contact <br /> DESCRIPTION WASTE MANIFEST# OTY RATE AMOUNT <br /> CODE <br /> Non RCRA Hazardous Waste, Liquid Used OII ❑Industrial O LubCA 221 C>(�O Spv7� JJK yOO `l <br /> ricatin <br /> Non RCRA Hazardous Waste,Liquid CA 223 <br /> Oil Water JJK - <br /> Non RCRA Hazardous Waste,Liquid CA 133 JJK <br /> Used Antifreeze <br /> Transportation <br /> Clor-D-Tec-Test <br /> PLEASE PAY FROM THIS INVOICE TERMS: NET 15 DAYS <br /> A service charge of 1.50e per month TOTAL <br /> shall be charged on past due accounts. �_ t) <br /> Consolidated Manifest Source: ❑Collection Station ;&industrial PO# <br /> ❑Marine ❑Agricultdral ❑Govt. Check# <br /> TSDF: Some facilities may ship oil out of state for processing and recycling <br /> ❑Ramos Environmental SeMt:es ❑California Oil Transfer 0 BEST Environmental,LLC ❑Bayside Oil II,Inc. ❑l DIXON ❑AES-Cores <br /> 1515 So.River Road 5300 Claus Road 2430 Almond Dr. 210 Encinal Street 7300 Chevron Way 1920 Morgan Rd. <br /> W Sacramento,CA 95691 Modesto,CA 95357 SilveriSprings,NV 89429 Santa Cruz,CA 95060 Dixon,CA 95620 Cama,CA 95307 <br /> CAD 044 003 556 CAL 000190 816 NVD 982 35B 483 CAD 088 838 222 CAT 080 012 602 CAL 000 393 680 <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL I <br /> This shipment of used oil may be transported to a facility that is required to comply with federal regulations applicable to management <br /> of used oil, but that isnot required to comply with the,more stringent requirements applicable to hazardous waste management facilities. <br /> California facilities that handle or process used oil are frequired to meet those more stringent requirements, and some out-of-state <br /> facifitfes that process used oil also meet those requirements. These include more stringent leak detection and prevention requirements, <br /> engleearing certifications of tank integrity,and financial assurances for closure and accidental releases.It is lawful to send used oil to out-of-state <br /> facilitt6s that comply only with federal used oil management standards and not these more stringent requirements. <br /> Generator certifies that the above named waste stream has not been mixed <br /> with any other waste. Furthermore it has established a program to reduce <br /> ll the volume'&toxicity of waste generated where economically practicable. <br /> Driver Sig ature Truck# Generator Signature Print <br /> Please keep a copy of this.invoice in a"Hazardous Waste"file for three(3)years as required by State law. <br /> EPA#CAL000188867 DTSC#3670 CA339919 <br /> 164 Robles Way,#207,Vallejo,CA 94591 •Office 707-552-8419•Fax 707-648-2804 <br /> 1-888-609-2MAX or 1-888-700-4MAX <br />