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AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice NI-11111)ff: <br /> P. O. Box 340' - Delhi, CA 95315 <br /> PH. 1-800-732-4645 - FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> X q, <br /> Phone Customer P-0. Payment Terms <br /> — i1` t 'i— <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> - <br /> USED OIL NON RCRA HAZARDOUS ,-,( <br /> WASTE LIQUID 221 IN <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 1 <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE N/A <br /> HAZARDOUS WASTE LIQUID <br /> '10 01 <br /> Vr , V <br /> TRUCK TIME N/A <br /> ---ED <br /> GREASWEEP N/A N ��Xxl <br /> 4e�//j rl <br /> Tto <br /> Emet-ided Life Premk recycled Avtdre"ze <br /> "i H 3U R CHAR GE <br /> I hereby certify that I have not mixed this waste with any other waste,that the total halides are less th,0 Ybob/P.P. .:and that <br /> the waste does not contain any P.C.B.'s.I further agree to accept the additional charges for legal disposal if this waste is over <br /> TAL <br /> 1000 P.P.M.total halides,or containes a P.C. TO <br /> DRIVER GENERATOR/SIGNATURE <br /> AUTHORIZED <br /> SIGNATURE 0'D7YRESIGNATURE <br /> TERMS: INVOICES OVE <br /> SUBJECT 1.5%SERVICE CHARGE.CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br /> ^ 0 ` <br /> COURT ACTION BECOf,4ES NECESSARY TO COLLECT THIS INVOICE. <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 /> 'r <br /> This notification is for infor pur ses only. <br /> ;o' -7 <br /> 6 "Z <br /> Driver signed Date Generator signed Date-�—, <br /> vo'c' if, <br /> r certifies that the gerierator has established a program to reduce the volume or"quantity and toxicity of the hazardous <br /> By signing the invoice <br /> waste to the degree, s deterZed by the generator,to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that American Valley will submit confirmations for(certain waste streams)to the generator <br /> that their waste has been transported to a license treatment or transfer facility. <br /> DISPOSAL/ RECYCLING FACILITY <br /> O,-RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD-W. SACRAMENTO, CA 95691 <br /> 209-863-8181 -EPA#CALOOO 190816 916-371-5747- EPA#CAD044003556 <br /> MPC(1012004) <br />