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05/1111999 22:19 2093692621 D AND R ROEK <br />OAMERICAN VALLEY <br />WASTE OIL, INC. <br />P. O. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 • FAX 209-668.3880 <br />EPA, CAL000827878 <br />BILI. TO: JOB SITE. KHA!�� AU O <br />KHA91,3 AUTO 120 E. L. nl <br />720 E. L(A)I LOOI, C -A 95-240 <br />L00I, ICA 95240 <br />Pyyh,...��o�rne Customer P.O. <br />Payment Terms <br />/ <br />�� /\meq( [ MATH <br />20-�Y-�/i,f M.,'l;HFW <br />Com. (.il. _6 <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST <br />CODE <br />USED OIL NON RCRA HAZARDOUS <br />221 <br />0 , <br />WASTE LIQUID <br />USED AUTOMOTIVE ANTIFREEZE, NON <br />RCRA HAZARDOUS WASTE LIQUID <br />343 <br />OILY WATER, NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />TRINITY HEAVY DUTY PREMIX <br />RECYCLED ANTIFREEZE <br />N/A <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />i rfroq r E)dendul Life PremrA W,rl- cd Antiff•eez <br />PAGE 02 <br />04 <br />Invoice Number: <br />/a-�_oe <br />Invoice Date: <br />EPA# <br />QUANTITY PRICE AMeldwr <br />t' <br />I hard p11 *At I have not mbrad this warts with any other 1NWI$, that the total halides are less than 1000 P.P.M.: and that <br />the 'A01: contain any P.C.B. a. 1 further agree to accept the additional charges for legal disposal if this w991e Is over <br />TOTAL , J <br />1000 ►fides. or contehes P.C.I3. s. <br />DRIVE{",:='.` ' GENERATOR AUTHORIZED <br />SIGNATUAt ._ SIGNATURE SIGNATURE <br />INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES,TO PAY ALL LEGAL FEES IF <br />MW AL'T1ON BECOMES NECESSARY TO COLLECT THIS INVOICE. <br />Amwican Valley Waste Oa hereby sdvisais the above Generator the Generators shipment of used oil may be tranaported to a facility that Is required to oompiy <br />with federal regimwns applicable to management of used olt, but that is not required to comply with the mere atflngent requlremer" a01p.6fe to hazanioua <br />waste managament facukles. Caldomia facluties that handle or process used oil are required to meat those more stringent requwansrtls, and sorra out-of- <br />state faicattiees that process used o/ also meet afore requirements, engineering certifications of tank into". and finendal as mamoss for closure and <br />amidentW releasee, it Is lawful to Send used oil 10 out-of-state fedlitfes that comply only wilt► federai used ori management staftdaift aril not dwee more <br />selrtperd requirements. <br />This notification is for InformaWn purposes! only. <br />Driver signed Date Generator signed -Bats <br />By -g—g the Invoice tiw generator certifies that the generator has established a program to reduce the volume or quantity and Umicity of dw hazardous <br />waste to the degree, as determined by the genefatur, to be oconomlcafty practicable. <br />By both parties signing this Inwa it will serve as an agreement that American Valley will sutxnit taortfirmetlons for (ceflain waste stream) to trte gsrterator <br />k <br />that their waste has been transported to a Beans@ treatment or transfer facility. <br />DISP03AL / RECYCLING FACILITY <br />O RIVERBANK 0,11 -TRANSFER O RAMvt3 ENVIRONMENTAL SERVICES <br />5300 CLAUS ROAD • RIVERBANK, CA 95387 1515 SOUTH RIVER ROAD - W. SACRAMENTO, CA 95691 <br />200-883-81 01 • EPA 40 CAL0001Wei 6 916-371-6747 • EPA M CAD044003566 <br />