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AMERICAN VALLEY I0 '1437 <br /> WASTE-01t, INC. Invoice Number: <br /> P 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> CBILI:TO:ASSOCIATED TCTOR JOB SITE:AE;&(OA1EDTFA TOR Invoice Date: <br /> i 1323W,'CHARTER WY :.23rid CHAR IERWAY <br /> 81 O K r0N,CA 95 X:AW--;ONALJT&FRESNO <br /> 8 f OCKTON,CA '-A,2D6 <br /> Ph Customer RQ"' Ter EPA#;, <br /> R3 6 ROCKY 3t) Days ;A09 0619 0 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> i I <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Antifreeze <br /> Trinity Extended Life premixed Antifreeze <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees it court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that 1 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 <br /> contain any P.C.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 P.P.M.total halides,or contains any P.C.B's <br /> Generator's Certification: By signing I certify that I have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree I <br /> have determined to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the. <br /> generator that their waste has been transported to a licensed treatment or transfer facility. <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 information purposes only. <br /> a <br /> GENERATOPo <br /> DRIVERr M'r /� f',✓ AUTHORIZED i.- <br /> SIGNATURE'',^' ff�,f✓ DATE ^ SIGNATURE Y- , `.-1 h DATE <br /> O NAME. DISPOSAL/ RECYCLING FACILITY <br /> ADDRESS: -(�)`DK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> DIT4lST: 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> DIXON,CA 95620 W.SACRAMENTO,CA 95691 <br /> PHONE: 707-693-6008 916-371-5747 <br /> EPA4 EPA#CAT080012602 EPA#CAD044003556 <br /> MPG(4/2010) <br />