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,-�MERICAN VALLE, 17 <br /> WASTE Oil., INC. Invoice Number: <br /> P. 0. Box 340 - Delhi, CA 95315 <br /> PH, 1-800-732-4645 - FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> Foy? QVrE. <br /> BILL TO: -VJFa 60Y TFAiLER-'--'� <br /> TUFF &':?Y TRAILERS tjl 151 E. ALMONDWOOD <br /> Y 0 S 194,T E-- <br /> Cti I C,C k'T("rj IlA 9 <br /> Phone Customer P.O. Payment Terms n I <br /> 4 4 <br /> 201�; 23U 136Z-1 PRICE <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS Z4 l(i <br /> PRODUCT <br /> T SHIPPING <br /> P <br /> NON RCRA PIN <br /> AH G DES <br /> WASTE CODE D <br /> E <br /> E <br /> USED OIL 0 AZARDOUS 221 <br /> WASTE LIQUID <br /> T <br /> USED AUTOMOTIVE ANTIFREEZE, <br /> OUS ST LIQUID 343 <br /> RCRA HAZARDOUS WASTE LIQUID <br /> OILY WATER, NON RCRA HAZARDOUS <br /> 221 <br /> WASTE LIQUID <br /> TRINITY HEAVY DUTY PREMIX N/A <br /> r'-'-YCLED ANTIFREEZE <br /> HAZARDOUS WASTE LIQUID <br /> N/A <br /> TRUCK TIME <br /> GREASWEEP N/A <br /> 4-0i-y Exteroded LifePl-emm recycled Ardifrmze <br /> I hereby certify that I have not mixed this waste with any other waste,that the total halides are less than 1 000thal <br /> I further agree to accept the additional charges for legal disposal if this waste is over TO <br /> the waste does not contain any P.C.B.'s. . TAL <br /> 1000 P.P.M.total halides,or containes any P.C.B.'s. GENERATOR/AUTHORIZED- <br /> ............................. <br /> DRIVER SIGNATURE/ SIGNATURE 4 <br /> SIGNATURESTOMER EES TO P LL/LEGAL FEES IF <br /> ASERVICE CHARGE.CU <br /> TERMS: INVOICES OV R 30 D S ARE SUBJECT TO <br /> COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br /> above Generator the Generators shipment of used oil may be transported to a facility that is required to comply <br /> American Valley waste Oil hereby advises the ti. tlf <br /> with federal regulations applicable to management of used oil,but that is not required to comply with he 0 S'I gent requirements applicable to hazardous <br /> ies that handle or Seng <br /> used oil are required to rr A 0 e stringent requirements,and some out-of- <br /> waste management facilities.California facilit ents, engineering certifications of tia k i ty, and'financial assurances for closure and <br /> state facilities that process used oil also meet those requirem <br /> oil to out-of-state facilities that comply only with feder4ir,,s0eoli management standards and not these more <br /> accidental releases. it is lawful to send used <br /> stringent requiremept's---) <br /> This notification is is I9j-0or9kation p poses only. 4' Date <br /> 51') (j 0 Generator signed <br /> Driver signed Date LUAiCity of the hazardous <br /> By signing theinvoice the ge rator certifies that the generator has established a program to reduce th jolume or qvarprty#1 id <br /> waste to the degree,as determined by the generator,to be economically practicable. <br /> ant that American Valley will submit confirmations for(certain waste streams)to the generator <br /> By both parties signing this invoice it will serve as an agreement <br /> at their waste has been transported to a license treatment or transfer facility. <br /> .,DISPOSAL/ RECYCLING FACILITY 0 RAMOS ENVIRONMENTAL SERV ICES <br /> 0r-RIVERBANK OIL TRANSFER 1515 SOUTH RIVER ROAD-W.SACRAMENTO,CA 95691 <br /> 5300 CLAUS ROAD-RIVERBANK, CA 95367 <br /> 916 371-5747 4 CAD044003556 <br /> 209-863-8181 •EPA#CAL0001 90816 MPC(1012004) <br /> L 'I !! TI-0 , '' z- <br /> 41( la t" U��7' <br />