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AMERICAN VALLF.R E j E I V E D:: 66,Z'30 <br />WASTE OIL, INC. Invoice Number: <br />SEP .08?015 <br />P.O. Box'340 • Delhi, CA 9531%. ! <br />PH -400-732-4645 • FAX 209=619 <br />CaL000s2�s7s ` P11FIONMENTAL <br />ra�aTu..�,�ebTeeen�,r tea/ <br />JOB SITE:Invoice Date: <br />NA , 4Jt M] 11 �,/]. 5�� W,. 0..(iV✓ j v V _ �� �N L C. <br />l , „, — <br />Phone _ r° <br />Customer P.O. <br />Terms <br />EPA# <br />a C_ <br />11 <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY: <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used OiVMixed Oils <br />221 r <br />�j <br />p�J C'(. <br />�•�% <br />NON-RCRA Wase Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used 00y Water <br />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 If court action <br />TOTAL <br />becomes necessm to collect this Invoice. <br />By siggning 1 herby. certify that l have not mi ed this waste with any other waste, that the total halides are less than 1000 RRM; and that the waste does not <br />contain any RC.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 PP.M. total halides, or contains: any P.C.B's <br />Generator's Certification: By signing 1 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 troth parties signing this invoice it will serve. as an agreement that American Valley Waste Oil will submit confirmation for (certaln waste streams) to the <br />generator that their waste has been transported to a licensed treatment or transfer,facillty. <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 Vuired to comply with the more stringent requirements applicable to hazardous <br />and some out-of- <br />waste managg,e�� ant facilities. California facilities that handle or process used;oll are required to meet those more stringent requirements, <br />state facilitie ',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-ot•state facilities that ompfy only with federal used oil management standards and not these more <br />stringent i6quirements. <br />This notification is for information purposes only. <br />'GENERATOR/ <br />DRIVER/ AUTHORIZED ,f <br />� <br />SIGNATURE: DAT(qJ /�?�f /� ( 816N.ATURE: '"" � DATE: <br />O NAME: - DISPOSAL/ F ECYCLING FACILITY( <br />ADDRESS: ;-O"6K DIXON O RAMOS ENVIRONMENTAL SERVICE <br />crrv(sT: 7300 CHgVRON WAY 1515 SOUTH RIVER ROAD <br />DIXON,-CA 95620 W, SACRAMENTO, CA 95691 <br />PHONE: 707-693-6008 916-371-5747 <br />EPA* EPA # CAT080012602 EPA # CAD044003556 <br />