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�. AMERICAN VALLEY WASTE OIL, INC. Invoice Number: P.O. Box 340 • Delhi, CA 95315 PH. 1-800-732-4645 • FAX 209-668-3880 EPA.CAL000827878 "Invoice Date: BILL TO: ;/ JOB SITE: P"e Customer P.O. Payment-TetlnS EPA,# # ,•, - f PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT CODE USED OIL NON RCRA HAZARDOUS WASTE LIQUID 221 USED AUTOMOTIVE ANTIFREEZE, NON RCRA HAZARDOUS WASTE LIQUID 343 OILY WATER, NON RCRA HAZARDOUS WASTE LIQUID 221 TRINITY HEAVY DUTY PREMIX RECYCLED ANTIFREEZE N/A NON HAZARDOUS WASTE LIQUID TRUCK TIME N/A G REASW E EP N/A 1rinfty Latenf!E' ! 'irC " t^t?. 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 the waste does not contain any PC.B:s.I further agree to accept the additional charges for legal disposal if this waste is war 1000 P.P.M.total halides,or container any PC.B.'s. - TOTAL DRIVER GENERATOR AUTHORIZED SIGNATURE SIGNATURE /SIGNATURE TERMS:INVOICEy9'6VER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE.CUSTOMER AGREES TO PAY ALL LEGAL FEES IF COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. 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 with federal regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facilities.California facilities that handle or process used oil are required to meet those more stringent requirements,and some out-of- state facilities that process used oil also meet those requirements, engineering certifications of tank integrity, and financial assurances for closure and 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 stringent requirements. This notification is for information purposes only. Driver signed - Date Generator signed Date By signing the ince the generator cerfifies that the generator has established a program to reduce the volume or-quantity and toxicity of the hazardous waste to the degree,as determined by the generator,to be economically practicable. 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 that their waste has been transported to a license treatment or transfer facility. DISPOSAL / RECYCLING FACILITY O DK-DIXON O RAMOS ENVIRONMENTAL SERVICES 7300 CHEVRON WAY• DIXON, CA 95620 1515 SOUTH RIVER ROAD•W.SACRAMENTO, CA 95691 800-727-2879•EPA#CAT080012602 916-371-5747• EPA#CAD044003556 MPC(01/2009;