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AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice Number: j <br /> I <br /> P.0.Box 340 r Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 . 7 <br /> BILL TO: JOB SITE:t EPRINO 60006: I olce Date: <br /> f.R VINE 2401.W MACARTHUR DRIVE <br /> 2825 RAILROAD.AVE TRACY CA 95376 <br /> CERES,CA 95307 3 MO OIL <br /> Sales tip:Steve <br /> Customer P.O. Terms EPA# <br /> Ph <br /> _833-4214 JOHN Net 30 DaYs CAL000045338 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste liquid Used Oil/Mixed Oils 221 � <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 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 agfion TOTAL ' <br /> becomes necessary to collect this invoice. <br /> 8y signing I herby 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 the waste does not <br /> contain any P.C.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 P.P.M.total halides,or contains any P.C.B's <br /> Generator's Certification: By signing I 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 both parties that th igrningwastehis invoice <br /> been itwill <br /> serve <br /> rtedas an a licnsed agreementtrethat American <br /> vallley waste oil will submit confirmation for(certain waste streams)tothe <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 reeqquired 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"•f0deral used FII management standards and not these more <br /> stringent requirements. <br /> This notification is for information purposes only. t , <br /> gf GENERATORI \� <br /> ff { AUTHORIZED ° <br /> DRIVER / - '1'� �2 DATE <br /> SIGNATUREf,fir, DATE: �r 7� SIGNATURE: >- <br /> O NAME: DISPOSAL/ RECYCLING FACILITY <br /> ADDRESS: 12,DK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> Clryrsr: DIXON,CA 95620 W.SACRAMENTO,CA 95691 <br /> PHONE: 707-693-6008 916-371-5747 <br /> EPA#CAT080012602 EPA#CAD044003556 <br /> EPA#: <br /> MPc(4 2010). <br />