Laserfiche WebLink
KHANS ALJT Q <br />720 E, LOL*)1 <br />LODI, , %A 9�04i ) <br />t%t-1jAr')' Au IQ <br />720 E: LCD) <br />LORI • Cts 95240 <br />Phone Customer P.O.I Payment Terms EPA# <br />2Dy-:367-9431 0 M AT►4t -VV V.0 (-y I CALOOM32331 <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 />.n <br />RCRA HAZARDOUS WASTE LIQUID <br />343 <br />OILY WATER, NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />TRINITY HEAVY DUTY PREMIX <br />, <br />RECYCLED ANTIFREEZE <br />N/A <br />'; `. -• / ` <br />�, <br />I ( <br />f <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />' •V* <br />GREASWEEP <br />N/A, <br />TrIn" EAefted Liffe Premix recycled Anilir <br />I hereby Certify that I have not mixed this waste with any other waste, that the total halides are less than 1000 P.P.M.; and Chet <br />the wrists does not contain any P.C.B.'s, I further agree to accept the additional charges for legal disposal if this waste Is over TOTAL i -;'G "a <br />1000 P.P.M. total halides, or Containes any P.0 -B -'s. <br />DRIVER GENERATOR/ AUTHORIZED <br />SIGNATURE l SIGNATURE SIGNATURE <br />TERMS. INVOICES OVER 30 DAYS ARE SUBJECT TO A 1-5% SERVICE CHARGE. CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br />COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE, <br />American Valley Waste O# hereby advises the above Generator the 68WtatOrs shipment Of used oil may be transported to a facility that Is required to comply <br />with federal regulations applicable to management of used oi, but fhat is not required to Comply with the more stringent requirements applicable to hazardous <br />waste management faclidies. Calilomie facilities that handle or process used oil are required to meet those more Stringent requirements, and some out-of- <br />state foatties that process used oB also meet those requirements, engineering certifications of tank integrity, and financial assurances for closure and <br />accidental releases. It is {awful to send used oY to out-ot-state facilities that comply only with federal used oil management standards and not those more <br />stringent requirements. <br />This notification is for information purposes only. <br />Driver signed Date —. Generator signed Date <br />By signing the Invoice the generator certifies that the generator has established a program to reduce the volume or quantity and ,toxicity of Vie hazardous <br />waste to the degree, as determined by the generator, to be economicaNy practicable - <br />By both parties signing this Invoice it will serve as an agreement that American Valley will submit confirmations for (certain waste Streams) to ria generator <br />that their waste has been transported to a license treatment or transfer facility. <br />p RECYCLING FACILITY, <br />O RAN105 ENVIRONMENTAL SERVICES <br />O RIVERBANK OIL TRANSFER <br />5300 CLAUS ROAD • RIVERBANK. CA 95387 1515 SOUTH RIVER ROAD • W- SACRAMENTO, CA 951381 <br />2179-863-8181 • EPA N CAh0001t308tB 9113-371-5747 • EPA N CADD44003958 <br />Z0 39dd A1302 d QNV Q TZ9Z696613Z Z5:Z9 666T/5T/58 <br />