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JAN. 14. 2005 3: 15PM I#OLLISION DIVISION N0. 864 3P. 4 <br /> LaIML`WCAN VALLE10 "4.0987 <br /> 'WASTE OIL, INC. Invoice Number; <br /> P. 0, Box 340 , Delhi, CA 95315 „ <br /> PH, 1.800.732.4645 • FAX 209.668.3880 <br /> EPA. CAL000827878 <br /> -40 <br /> Involce Date: <br /> BELL TO: JOB SITE: <br /> i.NTE'RSTATi: COLLISION DIVISION LN'TL''RSITME r OLLISI'ON ,DTV18CN <br /> W.0 SOX 646? 641 , HARRISON <br /> tiT1r:ICT:N, A. ySGC'H _:TiAMONr CA 95206 <br /> X: S4l7TT <br /> Phone Customer RO, 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 ANTIKREEZF. 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 NIA <br /> GREASWI=EP N/A <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 n , <br /> the waste dges not contain any P.C.B.'s.I further agree to apoept the additional charges for legal disposal If this waste Is over OTAL ,S� <br /> 1000 P.P.M.total halides,or contalnes any P.0,5,V. !'' <br /> DRIVER / " ;,/ GENERATOR AUTHORIZES <br /> SIGNATURE ✓ r'" '. SIGNAT E/SIGNATURETERMS:INVOICES!INVOICES! VER ad'DAYS ARE SUBJECT TO A 1.5%SERVIC CHARGE.CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br /> COURT ACTION BECOMES IVr c55M,t, ,v �� c hw i,V�01C6'. <br /> AmgtiOan Valley Waste 011 hereby advises the above Generator the Generators shipment used oil may be.transported to a facility that Is required to comply <br /> wuh federal regulations appllcablo to management of usea oil,but that is not required to comply with the morn stringent requirements applicable to hazardous <br /> waste management facilities.California facilities that handle or process used oil aw gired�to meet those more stringent requirements,and some out-of- <br /> stale facilities that process used oil also meet those requirements, engineering c Ilbns of tpIt,�ntegn y, nd 'nandal assurances for closure and <br /> accidental releases: It is lawful to send used all to oul-of-state facilities that comply on with tedatal uUJ art ment standards and not these more <br /> stringent requirements. ') ' <br /> This notification Is for <br /> /'u1}omlatfon p4rfi0se ,6nly. <br /> n Driver signed +' : % Date) a)t'iatorsigned, "'�'e''(N� T:s- -�'''�"" Dere r <br /> By signing lit ' voice the go rotor certifies that the g6ndratoY nae established a program t6 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 /> DISEMAL/ RECYCLING FACILITY <br /> RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD•RIVERBANK,CA 95357 1515 SOUTH RIVER ROAD,W.SACRAMENTO,CA g5691 <br /> 209.863.8181 •EPA#CAL000100816 918.371.5747•EPA#CAD044003556 <br /> MPC(1 OIR004 <br />