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Mar 12 09 08: 25a tom price 209-365-6781 p. 3 <br /> AMERICAN VALLEY` <br /> WASTE OIL, INC. Invoice Number: <br /> R O. Box 340 • Delhi, CA 95315 77961 <br /> !� PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: GASOLINE ALLEY <br /> GASOLINE ALLEY 820 S. BECKMAN RD <br /> 820 S. BECKMAN RD LODI CA 95240 <br /> LODI, CA 95240 <br /> C" <br /> Salsa E=fWARDGARCIA <br /> Phone Customer P.O. PayRle t Terms EPA# <br /> 209-365-6747 TOM Net 30 Days CAL000267320 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 2C?. l? 1 � '•� 1 �� <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILY WATER, NON RCRA HAZARDOUS 221 <br /> WASTE LIQUID <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> G REAS W EEP N/A <br /> Trinity Edended Life Premix recycled Arditreez <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 that <br /> the waste does not contain any P.C.B.'s.I further agree to accept the additional charges for legal disposal 4 this waste is over TOTAL W <br /> 1000 P.P.M.total halides,or contains arty P.C.B.'s. <br /> DRIVER GENERATOR AUTHORIZED <br /> SIGNATURE ' --- SIGNATURE I 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 Oil hereby advises the above Generator the Generators shipment of used oil may be transported to a facility 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 applicable 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 facilities that process used oil also meet 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 requirements. <br /> This notification is for in/���rr��do purposes only. .! ; <br /> Driver signed <br /> _-- —"1$ate Z' µa 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 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 streams)to the generator <br /> that their waste has been transported to a license treatment or transfer facility. <br /> dd <br /> DISPOSAL/ RECYCLING FACILITY <br /> /V +RNERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W_SACRAMENTO,CA 95691 <br />