Laserfiche WebLink
0 AMERICAN VALLEYO <br /> WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 73479 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> "MAI fOAQUTAi O't•r, SAID J(1EQU-1I4 RE(>a'i NAL, <br /> n.`rT?I: ACX701INT.; aa'rAFtl. DI51. <br /> 15♦?:3 E. LINDSA's` :;'r ATTN: FL IN^"ENANCI. , DEPT <br /> ,. <br /> :'Tflr[�'•`?'t'1Ad, ! �l'd. rl��tjc �.;i.7.,3 E. ).,.f.ZSD`..{�}';` :+1n <br /> Phone Customer P.O. Payment Terms EPA# <br /> PI ( I '1 <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 iAk ?` <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE N/A t(') <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> frelttly Extended Life: Piremix recVa ism A€life ::e <br /> Fr.. moi: CHAROE <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 <br /> the waste does not contain any P.C.B:s.I further agree to accept the additional charges for legal disposal If this waste is over <br /> 1000 P.P.M.total halides,or TOTAL e4 any P.C.B.'s. <br /> DRIVER GENERATOR/AUTHORIZED <br /> SIGNATURE _._-,... SIGNATURE SIGNATURE <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE.CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br /> COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <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 required to comply with the more 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 <br /> accidental 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 <br /> stringent requirements. <br /> This notification is for information purposes only. <br /> Driver signed Date Generator signed Date <br /> By signing the invoice the generator certifies that the generator has established a program to 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 /> DISPOSAL/ RECYCLING FACILITY <br /> O RIVERBANK OIL TRANSFER .,GIIAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD•RIVERBANK,CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO, CA 95691 <br /> 209-863-8181 •EPA 4 CAL000190816 916-371-5747•EPA#CA0044003556 <br /> MPG liar <br />