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AMERICAN VALLEY <br />87320 <br />WASTE OIL, INC. <br />Invoice Number: <br />P.O. Box 340 - Delhi, CA 9531 S <br />PH. 1-800-732-4645 • FAX 209-868-3880 <br />EPA. CAL000827878 <br />WASTE <br />MANIFEST <br />Invoice Date: <br />BILL TO: KHANS AUTO <br />ME: KHA"45 AUTO <br />LODI, CA 952401 CA 95424 (0) <br />a sal &$ Rep <br />P <br />67-96717 MA-P+--w�) <br />Customer PO. <br />- Pey9tr�h Terms <br />EP <br />' ;pi_(iCXX�323;x1 <br />l ; <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 />USED AUTOMOTIVE ANTIFREEZE, NON <br />`= <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 />Trinity Exteided Life Premfx recycled ANif-eez <br />' <br />I hereby cerYfy "t I (lave not mixed this waste with any other waste, that the total halides are less than 1000 P.P.M.; and Urat <br />the waste does not contain any P,C.B:s. I further agree to accept the additional charges for legal disposal if this waste is over T�w <br />-1 <br />1000 P.P.M. total halides, or con a P.C.B's. 1 M <br />DRIVER-- GENERATOR /AUTHORIZED 'r <br />SIGNATURE SIGNATURE SIGNATURE <br />TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES PAY ALL LEGAL FEES IF <br />COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br />American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may be transported to a todity that Is required to comply <br />with federal regulations applicable to management of used oil, but that is not required to comply with the more stringent requirements appkable to hazardous <br />waste management facilities. California faciftes that handle or process used all are required to meet those more stringant raquirertents, and some out-of- <br />state facilities that process used oil also most those requirements, engineering certifications of tank integrity, and financial assurances for closure and <br />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 <br />stringent r"ulrements. <br />This notification Is for krtormation purposes only. <br />Driver signed Date Generator signed Date <br />By signing the Invoice the generator certifies that the generator has estabiished a program to reduce the volume or quantity end toxicity of the hazardous <br />waste to the degree, as determined by the generator, to be economically practicable - <br />By both parties signing this Invoice it will serve as an agreement that American Valley will submit confirmations for (certain waste atraotrm) to the generator <br />that their waste has been transported to a license treatment or transfer facility. <br />QISPQSAL / RECYCLING FACILITY <br />0 DK-DIXON O RAMOS ENVIRONMEWAL SERVICES <br />7300 CHEVRON WAY - DIXON, CA 95620 1515 SOUTH RIVER ROAD • W. SACRAMENTO, CA 95891 <br />ann. vn�— _ eft. r -.r ------ — — — -.-.- — .. � . -- - ------- <br />c0 dJad A30�J d QNV Q TZ9Z69CG0Z 95:Z0 6662/5T/90 <br />