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' AMERICAN VALLEY 49363 <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 CAL000827878 <br /> Invoice Date <br />' BELL TO: JOB SITE. <br /> {lfyrl(t4et ` "G' C j_'`f , r.},C=' `+ <br /> AF•1 .�'r-f, '�' y <br /> � <br />' Phone Customer PO Payment Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br />' USED OIL NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <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 />' lg&CYCLED ANTIFREEZE N/A <br /> 1N HAZARDOUS WASTE LIQUID <br /> TRUCK TIME NIA <br /> GREASWEEP N/A <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 PC 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 PC B's <br />' DRIVER GENERATOR AUTHORIZED <br /> SIGNATURE SIGNATURE / SIGNATURE <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 50/a SERVICE CHARGE CUSTOMER AGREES TO PAY 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 requirements <br /> This notification is for information purposes only <br />' Driver signedI Date Generator signed Date <br /> Bsigning the invoice the generator certifies that the generator has established a program to reduce the volume or quantit and toxicity of the hazardous <br /> ste to the degree as determined by the generator to be economically practicable <br /> y <br /> 6both parties signing this invoice it will serve as an agreement that American Valley will submit confirmations for(certain waste streams) to the generator <br />' it 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(1012004 <br />