Laserfiche WebLink
BILL TO: KHANS AUTO <br />720 F. LODI <br />LOLA, CA 9,5240 <br />AmERiCAN VALLEY,. 87319 <br />WASTE OIL, INC. Invoice Number: <br />P. O. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />EPA. CAL000827878 <br />JOB SITE: KHANS AUTO <br />7 2 (' F. LCX) I <br />LODi CA 95240 <br />:igibs `�P: <br />Invoice ate: <br />P <br />s7 -Nese MATHFVY <br />Customer P.O. <br />Payment Terms <br />r n r. <br />EPA ;r <br />!,,AL[10M32331 <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />USED OIL NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />MCI <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 />WA <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />Trinity Odelided LI a Premix recyclefl Argilre z <br />• <br />,J <br />I hereby certify that I haw not mbed this waste with any other waste, that the total halides are lose than 1000 P.P.M.; and that <br />the waste does not contain any P.C.11s. I further agree to accept the additional charges for legal disposal if this waste is over <br />AL <br />1000 PRM. total halides, or c onbWnes any PC.9'e. <br />DRIVER „ GENERATOR/ AUTHORIZED <br />SIGNATURE ' SIGNATURE SIGNATURE f 'r•' it > `r^ <br />TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTom;A AGRElkgjdAY ALL LEGAL FEES IF <br />COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br />American Valley Waste Oil hereby advisee the above Generator the Genarators shipment of used oil may be transported tg a Witt# that is required to oom;ily <br />with federal regulations applicable to r uvwgement of used oil, tot that is riot required to comply with the more stringent *uirem ants appkable to hazardous <br />waste management facilities. California facilities that handle or process used oil are required to meet those more stringent requirements, and some out-of- <br />state faoHltlos that process used oil also most those requirements, ,engineering certifications of tank Integrity, and ttnanclof am ra nces for closure and <br />accidental releases, it is lawful to send used oN to out=of-state tacllit)ea*V%at comply only with federal used oil management htandards and not these more <br />stringent rvgwrements. <br />Thio nodfica ton lap forr, ir)formaAon purposes only. /` ? <br />^ <br />Drtmr signed - I✓�. ` Date ` 4 Generator signed'7 <br />By signing the Invoic a genemor certifies that the generator has established a program 1d reduce the Skme'or quantity and tozk4 aat the hazes tm <br />waste to pts degree. as determined by the generator, to be economically practicable. <br />By both parpes signing this Invoice it will serve as an agreement that American Valley will submit confirmations for (certain waste streams) to the gwwfator <br />OW their waste has been transported to a license trsatmsrd or transfer faditty. <br />DISPOSAL / RECYCLING FACILITY <br />O DK-DIXON G -fin m ENVIRONMENTAL SERVICES <br />7300 CHEVRON WAY • DtXON, CA 95620 1515 SOUTH RIVER ROAD - W_ SACRAMENTO, CA 98691 <br />Z0 39ad A30d d QNV Q TZK69660Z 95:Z0 666T/5T/50 <br />