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AMERICAN VALLEY 8-3 5 6 2 <br /> WASTE OIL, INC. Invoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645..E FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: GRUPE COMMERCIAL JOB SITE: GRUPE COMMERCIAL <br /> 604 E. ACACIA ST 604 E. ACACIA ST <br /> STOCKTON, CA 9-5202 STOCKTON, CA 95202 <br /> y <br /> Safes Rep: <br /> -Q403-7438 CHRIS Customer P.O. Payr�g t 3C3rtjdyS EPAtALQC104 88139 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODEUSED / G <br /> WASTEOIL LIQ OND RCRA HAZARDOUS 221 2W I��S 'd <br /> 4b,CXR <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 - - <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> Trinity -Aended Life Premix recycled Antifreeze <br /> I hereby 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 <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 TOTAL) <br /> 1000 P.P.M.total halides,or containes any P.C.B.'s. <br /> DRIVER ,. GENERATOR AUTHORIZED <br /> SIGNATURE SIGNATURE /SIGNATURE <br /> TERMS: INVOICES C+�VER 0 dAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES tb P4 ALL LEGAL FEES IF <br /> COURT ACTION BECOMES 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 re <br /> quireme"K. <br /> ..^ i <br /> This notification is for in o tio` urposes only. ?AI <br /> Driver signed Date Generator signed �( ZA.A at� <br /> By signing the my/ice the nerator certifies that the generator has established a program to reduce t e vo ume o quan ity!iPd toxicity o rFt?Rf <br /> waste to the degree,as d4termined 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 O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD•RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO, CA 95691 <br /> 209-863-8181 • EPA#CAL000190816 916-371-5747• EPA# CAD044003556 <br /> MPC(10/2004) <br />