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A ILRI(-IAN VAL1,EY <br />WASTE OIL, INC. <br />:i 3136 <br />Invoice Number: <br />R O. BOX 340 - Delhi, CA 95315 <br />PH. 1-800-732-46-S - FAX 209-CC8-388CI <br />CAL700827878 <br />BILL TO: JIM THORPE OIL INC JOB S11 E:I t Invoice DattC: <br />P.O. BOX 357 64844WAVAVEFrLY RD <br />LODI, CA 95241 LiNOEN, CA 3.5326 <br />C AOI) 12216487 <br />/�lti (y <br />-- - <br />Ph Customer P.O: Ter s EPA# <br />�ii 462-4581 <br />et 30 Gays CAL00012684 <br />PRODUCT SHIPPING DESCRIPTION MANIFEST OUANTITY1 PRICE AMOUNT <br />WASTE <br />COBE <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 c i t r"Jr i'fl y''c <br />NON Hazardous Waste Liquid <br />Trinity Heavy Duty premixed Antifreeze — t <br />Trinity Extended Life premixed Antifreeze i —� <br />— — — -- <br />r-------------- <br />Trinity Case Goods <br />Truck Wash Out <br />Truck Time <br />t <br />TERMS t Invoices over 30 Days are subject [o a i.S I service charge. Customer agrees to pay all legal fees it court action TOTAL <br />beeomos necessary to collect this invoice_ <br />By signing I herby certify that I have not nixed this waste with any other waste; that3he total halided <br />s are less than 1000 PRIA, and that the waste does not <br />certain any PC -B's I further agree to accept the addaronal chargealfor legal disposal If ths'wasts(is Quer 1000 RPM total halides, or contains any PC.a's <br />Generator's Certification. BY signing I gerti(y chat I have a program ln,place to rail -tog tfia volume and toxipHy ct hazardous waste generated to the degree <br />have determined to be economically practicable .. " -: <br />By both parties signing this invoice It will serve as an agreement that American Ua(@}%Y1rasS,�.,tj7I W4Ij w1bintit donfirma�don for (cortin waste streams) to -the <br />hn <br />generator that their waste as beetranaiiorted to a I ceno d treatment or lfansfefe gutty. - -' <br />American Valley Waste Oil hereby advysas,.tj7a above Gatt&t'dtprt)t@ fa,qrplars.shipment of usedoil may be transported to a facility that. is required to gampry. <br />with federal regulations applicable to moirl,99ament of u , d O'ottit&tis P.Rt 6, vire to comply it the more atang pt reg4ire arta at>pltcaMe to haZe(d945, <br />waste management faGi6tres- California'fac0ities'tflat t;dl dr prBG,eHS Use bare redui(etf tfi{meat I , s ina np�rgi aments and some out-cri <br />state facliRies that process used oil also 7naet those requirements, lenginugi ng aertillcatlen, of lank iota rift' a d tIrj�h essurences for ctosure and <br />accidental releases. It is lawful to send used oil to. out-of-state facilities tha- comply only. with federal used. it man go a t at retards .and not -these more <br />sUingent requirements. <br />This notification is for information puri ores only. j <br />" f GENERATQRr � N <br />� r <br />DRIVER �-- _ y�� aUTHGRIZEO I <br />- f <br />� � '' � i <br />SIGNATURE: JA�� ATE' <br />f/' DE �51GN„TUI,E � ' <br />--- <br />D � <br />O NAME __-- - _ S _O_ SAL R E Y L) F� I LIT <br />C) DK.DIXON RAMO 1FNVIR NMENTAL SERVICE <br />OTWST. 7300 CHEVRON WA 515. SO1 TH R ER ROAD .. <br />_ <br />_-- --- DIXON, CA 95620 W. SACRAMEN CA 95691 <br />PHONE: 707-698-6008 916.371.5747 - <br />Ef'Aa. EPA 0 CAT080012602 EPA # CAD0441 <br />MPC Nr201u <br />