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BILL TO: JIM THORPE OIL INC <br />P.O. BOX 357 <br />LODI, CA 95241 <br />'AMERICAN VALLEY <br />96259 <br />WASTE OIL, INC, <br />Invoice Number: <br />P.O. Box 340 • Delhi,, CA 95315 <br />*' <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />CAL000827878 <br />JOB SITE: MC BILLIN REALESATE <br />QUANTITY <br />Invoice Date: <br />2154 S- EL DORADO ST <br />STOCKTON, CA 95203 <br />CAC0000026�5/7/568 <br />e)n � � 11'n <br />Sales Rep: Steve <br />Pho e <br />2t�9-462-4581 <br />Customer P.O. <br />Terms <br />EPA# 5 <br />*' <br />et 30 Dayewmw �,tr <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />IOC9® <br />NON Hazardous Waste Liquid <br />% ')Ie <br />I 0� <br />{� �� s _ <br />/ \ <br />7 <br />Trinity Heavy Duty premixed Antifreeze <br />G/ a 5 <br />9 G <br />Trinity Extended Life premixed Antifreeze <br />£/yJOU£ <br />I <br />Trinity Case Goods <br />Truck Wash Out <br />Truck Time <br />I <br />� <br />L <br />TERMS:. Invoices over 30 Days are subject to a 1.5 % service charge. Customer agrees to pay all legal fees if court action <br />TOTAL <br />becomes necessary to collect this invoice. <br />By 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 />µ ,. <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 signing this invoice it will 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 Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may be transported to afacility 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, oWginaering certifications of tank integrity, and financial assurances for closure and <br />accidental releases. Itja law�p�,ue�ct 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 />.0 <br />GENERATOR/ <br />AUTHORIZED! <br />DRIVERSIGNATURE:\-"""'-^�---- <br />`'�` ATE: —� <br />DATE: , v`1FJ� V j <br />Tt <br />O NAME DISPOSAL/ RE CL NG FA ILITY <br />AAMREss: O DK-DIXON O RAMOS NVIRONMENTAL SERVICE <br />CITY/ST. 7300.CHEVRON WAY 1515 SOUTH RIVER ROAD <br />„ DIXON, CA 95620 W. SACRAMENTO, CA 95691 <br />PHONE- 707-693-6008916-371-5747 <br />EPA#: EPA # CAT080012602 EPA # CAD044003556 <br />MPC (4/2010) <br />