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D6/25/2012 11:00 2093344684 #4296 P.004 /004 <br /> AMEMCAN VALLEY 1;; <br /> WASTE OIL, INC. invoice Number: <br /> P O. Box 340 • Delhi, CA 95315 <br /> PH- 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> BILL TO: <br /> FLAME LIQUOR JOB SITE:FLAME LIQUOR Inv a pate: <br /> 1301 WEST ICETTLEMAN LN 1301 WEST KETTLE MAN LANE <br /> LODI.CA 95242 LODI,CA <br /> Phone Customer RO. Terms Sales MDSteve <br /> 217&334-3333 EPA# <br /> G4L000327685 " <br /> PRODUCT SHIPPING DESCRIPTION J WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oit/Mixed O!s 221 <br /> NON•RCRA Waste Liquid Used Antifreeze 133 <br /> NDN-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> I <br /> Trinity Heavy Duty premixed Antifreeze I t <br /> Trinity Extended Life premixed Antifreeze <br /> i <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time t <br /> � r <br /> TERMS: Invoices over So Days are subject to a t5%sON40 charge.Cust era real to <br /> bECOM6$necessary to collect this invoice. 9 9 pay al tees rf court action TOTAL <br /> Contain any P.C.e's. I further signing 1 herby car*rher athat have not mixed this waste with <br /> Coany other waste,that the total halides are less than 1000 PPM;and that the waste does not <br /> gree to accept the additional charges for legal disposal If the waste is over 1000 P,p,M,total halides,or contains any PC.e's <br /> Generator's Certification: By signing I certify that i have a program in pia0e to reduce the volume and toxicity of hazardous waste generated to the tlegree I <br /> have determined to be economically practicable. <br /> BY both parties signing this invoice rt wilt 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 Vallay Waste Oil hereby advises the above Generator the Generators shipment of used a1 may be transported to a facility that is required to comply <br /> waste a management regulations applicable management pf used oil,but that is not raquirod t0 compy with the more stringent requirements applicable to hazardous <br /> fdCiliies.Californiaof9cllide5 that handle or process used oil are required to meet those more stringent requirements,and some Oubof- <br /> state fatalities that p100e55 used oil also meet those requirements, engineering certifications of tank integrity, and financial assurances for cbsure and <br /> accidental releases.It is lawful to send used oil t0 outof-state facilities that comply only with tederal used oil managemerrt standards and not these more <br /> stringent requirements. <br /> This notification for information purposes only, <br /> DRIVER GENERATOW „ <br /> AUMR2ED <br /> SIGNATOR GATE: SIGNATURE; <br /> O NAME aC <br /> DISPOSAL/ RECYCLING FACILITY <br /> AODRESS: <br /> GIiY/5TDK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> : //// 7$00 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> PHONE: DIXON,CA 95620 W-SACRAMENTO,CA 95691 <br /> 707-693.6008 916-371-5747 <br /> EPAk: + EPA s CATOBOO12602 EPA#CAD044003556 V <br /> - - r,mc larzmel •. <br />