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RECEIVED <br /> AMERICAN vAI.LEY JUL '2 3 2013 115877 <br /> WASTE SIL, INC. ENVIRONMENTAL oiee Number: <br /> P 0.B0X 340 • Delhi, CA 95315 HEALTH DEPARTMENT <br /> PH. 1-800-732-4645', FAX 209-668-3880 <br /> CAL000827878 7 / <br /> BILL TO:FLAME LIQUOR <br /> 1301 WEST KETTLE LN JOB SITE:FLAAB <br /> � E LIQUOR <br /> LODI,CA 95242 1301 WEST KMLEM4N LANE invoice bate: <br /> LODI,CA <br /> P�M334-3333 Customer P.O. gf� ' ° <br /> TermsC 0 D. EPA# <br /> CAL0170327885 <br /> PRODUCT SHIPPING DESCRIPTION <br /> WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used 0lVMIXed Oils 221 <br /> NON-RCR4 Waste Liquid Used Antifreeze ; <br /> NON-RCRq Waste Liquid Used Oily Water 22$ <br /> NON Hazardous Waste Liquid rj <br /> Trinity Heavy Dirty premixed Antifreeze <br /> Trinity Extended Life premixed Antifreez8 <br /> f r <br /> II <br /> Trinity Case Goods <br /> Trude Wash Out — — — — <br /> Truck Time <br /> TERMS: Irrvoices over 30 Days aresubiect to a 1,5%service Charge. Customer tees to <br /> becomes necessary to coliea this invoice. a9 pay all legal fee,if court action TOTAL p <br /> By signing I he <br /> rby certify thdt I have not mixed this waste with any other waste,that the total halides are logs than 1000 RPM{and that the waste does not <br /> contain any P.c,us. I further agree to accept the additional charges for legal disposal if the waste's over 1000.PPM,total halides,or contains any RC.B's <br /> Generators Certification: Signing!certify that I have a program in plana to reduce the volume and toxicity of hazardous waste generated to'the degree I <br /> geElynerator <br /> S l <br /> have determined to he economically practicable. <br /> both Parfitt signing this invoice h will serve as agreement that American Valley Waste oil will submit Confirmation for(certain waste streams to the <br /> generator tnat their waste has been transported to a licensed treatment Or transfer facility. ) <br /> waAmerican Valley Waste Oil hereby advises me above Generator the Generators shipment of used al may be transported to a facility that is required to Com <br /> s federal regulationsmeaf applicable to management of used oil,but that is not required to comply with the more stringent applicable to hazardous <br /> waste management fadlifieS.California fadlities that handle or process used oil are required to meat those more d <br /> state facilities that 9e requirements <br /> Process'is la used oil also meet those requirements, engineering certifications of tank integrity, and f9^ancialq assurances for wme cfosure�a <br /> accidental releases.It is lawful to septi used oil to out-of-state facilities that comply only with federal used oil management ala assurances <br /> dards and not chase more <br /> stringent requirements. <br /> This notification is for information purposes only. <br /> i <br /> DRIVER ,j'� / 7 jY GENERATOW <br /> SIGNAMR'C: ADTtfORIZED _ <br /> SIGNATURE ' <br /> ✓'-..- DATE; � � <br /> Q NAMS: / <br /> AocaEss: <br /> D SPO AL / BECYCL NG F CILITY <br /> DK-DXON <br /> 7300 CHEVRON <br /> O RAMOS ENVIRONMENTAL SERVICE <br /> PHONE 7300 CHEVRON WAY <br /> 1575 SOUTH RIVER ROAD <br /> ?!SONE: D07�9 CA 95620 W SACRAMENTO,CA 95691 <br /> "ft con x r ... 916-371-5747 <br /> 900/ 600-d OSIS# 68966££60Z 56:OT £TOZ/£Z/LO <br />