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Mar 12 09 08: 26a tom price 209-365-6781 p. 5 <br /> AMERICAN VALLEY <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 /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> ...^;_ ,.. ,^.LLE-, G?;i i_IV;=Al t F <br /> y � <br /> Phone Customer P.O. Payment Terms EPA# "'` <br /> -,36. .-F,7 r 1 l ie': e <-•, ;' <br /> l: .IC r. <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS t •, =' <br /> WASTE LIQUID 221 ' <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID ° <br /> TRUCK TIME N/A ` <br /> GREASWEEP NIA <br /> r!'Ii'!):'•i '_�cf.':"n E'.t� I-lir; Pr#3nin( rew:-i&I nif i�fji.'2 <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 riot contain any P.C.B.'s.I further agree to accept the additional charges for legal disposal if this waste is over TOTAL.":., <br /> t0oo P.P.M.total halk4worr container any P.C.B.'s. <br /> DRIVER GENERATOR/AUTHORIZED <br /> SIGNATURE SIGNATURE I SIGNATURE <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.50%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.Callfomia 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,olawful 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 notificationis for information purposes only <br /> Driver signed Date f % 'f 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 /> DISPOSAL/ RECYCLING FACILITY <br /> 0 RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br />