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illk <br /> 41 1AMERICAN VALLEY 92305 <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 /> EPA. CALOOD827878 <br /> ?// F/ / n <br /> BILL TO: JOB SITE: Invoice Date: <br /> MERRY XRAY COMPANY MERRY XRAY COMPANY INC <br /> 1045 NATIONAL DR 1045 NATIONAL DR <br /> SACRAMENTO,CA 95834 SACRAMENTO,CA 95834 <br /> Sales nap <br /> Phone Customer P.O. Terms EPA# <br /> 916-928-0450.SHV Net 30 Days CALOOOIOO189 <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 Recycled Antifreeze <br /> Trin ityj Extended Life premixed Recycled Antifreeze <br /> Trinity Case Goads <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 it court action TOTAL <br /> becomes necessary to collect this invoice. U-) <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 /> Generators 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 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 GENERATOR AUTHORIZED <br /> SIGNATURE SIGNATURE./SIGNATURE C. <br /> DISPOSAL d RECYCLING FACILITY O NAME: <br /> IXONADDRESS: <br /> O RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD CITY/ST: <br /> DIXON,CA 95620 W.SACRAMENTO, CA 95691 <br /> PHONE: <br /> 707-693-6008 <br /> 916-371-5747 <br /> EPA#CAT080012602 EPA#CA0044003556 EPA#: <br /> MPC(10/2009) <br />