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Customer EPA # �. J d. Date: Driver EPA #CAL 000427808 State Manifest Document # CHP #CA192005 CRYSTAL BLUE INVOICE NO . 2959 ENVIRONMENTAL 7337 Herlong Way North Highlands , CA 95660 PAY FROM THIS INVOICE � .}. (415) 996= 3350 Transporters Registration No : 6104 Next P/U Date : CO . NAME PHONE ( ) ADDRESS V CITY � , � �` �� STATE ZIP QTY DESCRIPTION PRICE TOTAL Non - RCRA Hazardous Waste Liquid . Used oil/mixed oil . /per * No Placard required (221 ) gal Non - RCRA Hazardous Waste Liquid . Used anti -freeze . /per * No placard required (343) gal Non - RCRA Hazardous Waste Liquid . Oily water. /per * No placard required (223) gal 55 Gallon Drum filled with Used & drained oil & gas filters . % r4�C;. /per drum TOTAL -m*�- ❑ DESTINATION OF OIL ❑ ALTERNATIVES ❑ DESTINATION OF FILTERS RES AES 1616 S . River Road 14287 E . Manning Ave . 401 W. Channel Road West Sacramento , CA 95691 Parlier, CA 93648 Benicia, CA 94510 IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL. PLEASE SIGN AFTER READING . 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 regulations applicable to management of used oil , but that is not required to comply with the more stringent requirements applicable to hazardous waste man- agement facilities . California facilities that handle or process used oil are required to meet those more stringent requirements, and some out-of-state facilities that process used oil also meet those requirements . These include more stringent leak detection and prevention requirements, engineering certifications of tank 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 management standards and not these more stringent requirements . This notification is for information purposes only. GENERATORS CERTIFICATION : I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name, are classified , packed , marked , labeled , and are in all respects in proper condition for transport by highway according to applicable state and federal regulations . 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 to be economically practicable and that I have selected the practicable method of treatment, storage , or disposal currently available to me which minimizes the 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 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 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 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 information I have provided about this waste is incorrect. I hereby certify that all the information submitted in this and all attached documents contains true and accurate description of the waste . All relevant information Generator's Signature : regarding known or suspected hazards associated with the waste has been disclosed . I also certify that I have not Contact Person : mixed this waste with any other waste. Venue for purposes of enforcement shall be in Sacramento County. I declare Transporter's Signature : under perjury that the foregoing is true and correct. Term net 10 days . Finance charge of 2% per month (24% per year) on accounts not paid within 30 days . A $25 . 00 Fee will be charged for returned checks .