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10/ 06/ 2021 05 : 33PM 12098250041 SACRAMENTO WASTE OIL PAGE 01 / 10 <br /> 1 GIS; ( d�7� f Z <br /> Customer EPA #^ C � Date: <br /> — <br /> Driver EPA #CAL 913534912 C_JCp C�.aC} State Manif ) uu�iq <br /> CHP #CA68940 Vis <br /> SACRAMENTO WASTE OIL PAY FROM THIS INVOICE <br /> 4504 Dunnbury Way • Sacramento, CA 95842 INVOICE N0 , 5 7 0 8 t <br /> (J 1 6) 849 �01 44 <br /> Transporters Registration No: 3130 J Next P/U Date:/ <br /> CO. NAME1 r PHONE <br /> ADDRESS <br /> GITY STA _ ZIP 3 7 - <br /> OTY j DESCRIPTION PRICE TOTAL <br /> Non - RCRA Hazardous Waste Liquid , Used oil/mixed oil . /per <br /> 1E0 * No Placard required (221 ) gal 4qo <br /> Non� RCRA Hazardous Waste Liquid , Used anti-freeze . /per <br /> " No placard required (343) gal <br /> Non -RCRA Hazardous Waste Liquid , Used oil with water /per <br /> 'No Placard required (221 ) > 10% Water gal <br /> Non- RCRA Hazardous Waste Liquid , Oily water. <br /> " No placard required (223) <br /> ff <br /> TOTAL �► (� <br /> DESTINATION OF ALL LIQUIDS ALT. <br /> RES , W.O. Dixon W.O. Ceres <br /> 1515 S . River Read 7000 Chevron Way 1920 Morgan Rd <br /> west Sacramento, CA 95691 Dixon , CA 95620 Ceres 95358 <br /> CAD 044 003 556 CAT 080 012 602 CAL 000 393 680 <br /> IMPORTANT NOTICE REGARDING THE DISPOSITION OF YOUR USED OIL, PLEASE SIGN AFTER READING , <br /> Sacramento Waste Oil hereby advises the generator that your shipment of used oil may be transported to a facility that is requiried to comply with federal regula- <br /> (ions applicable to management of used oil, but that is not required to comply with the more stringent requirements applicable to hazardous waste management <br /> facilities. Celffornia facilities that handle or process used oil are required to meet those more stringent requirements , and some out-ofnstate facilities that; process <br /> used oil also meet those requirements, These include more stringent leak detection and prevention requirements, engineering certifications of tank integrity, and <br /> financial assurances for closure and accidental releases. It ie lawful to send used oil to out-of-state facilities that comply only with federal used oil management <br /> 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 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, 1 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 , etorege , 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 beat 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 1 . 000 ppm , and the waste does not contain any PCBs. I have complied with the requirements <br /> 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 <br /> Information I have provided about this wagIVs Incorrect, I hereby certify that all tlje information submitted in this and all attached documents contains true and <br /> accuraka description of the waste, All relevant information <br /> Generator's Signature: " �� regarding known or suspected hazards associated with <br /> r` 3' the waste has been disclosed , I also certify that I have not <br /> Contact Person : I 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 (2411/o per year) on accounts not paid within 30 days. <br /> A $ 45 , 001799 will be charged for retuned checks . <br />