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AMERICAN VALLEY 382�7 <br /> �CLE WASTE OIL, WC. Invoice Nwnber: <br /> RECP. O. Box 340 - Delhi, CA 95315 MED <br /> OV <br /> PH. 1-800-732-4645 - FAX 209-668-3880 <br /> EPA. CAL000827878 SEP 1 9 2005 <br /> 40-14r - <br /> ENVIRONMENT 0-1 <br /> HEALI"Invoice Date: <br /> PERMIT/SERVICES <br /> BILL TO: JOB SITE: <br /> '(YA i <br /> PhoneCustomer P.O. <br /> t Payment Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS <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 50/50 <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> TERMS:INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE.CUSTOMER AGREES <br /> TO PAY ALL LEGAL FEES IF COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. TOTAL <br /> DRIVER GENERATOR <br /> SIGNATURE <br /> SIGNATURE <br /> American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil ma�,be transported to a facility that is required to comply <br /> with federal regulations applicable to management of used 00,but that is not required to comply with the ff'we 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 acci- <br /> dental 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 strin- <br /> gent requirements. <br /> This notification is for information purposes only. <br /> Driver signed <br /> Date Generator signed Date <br /> By signing the invoice the generator certifies that the generator has established a program to reduce the volume <br /> waste to the degree,as determined by the generator,to be economically practicable. or quantity and toxicity of the hazardous <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 /> O RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD-RIVERBANK,CA 95367 1515 SOUTH RIVER ROAD-W.SACRAMENTO,CA 95691 <br /> 209-863-8181 -EPA#CAL0001 90816 916-371-5747-EPA#GAD044003556 <br /> MPC(4rAW <br />