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I <br />' AMERICAN VALLEY 49617 <br /> # <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 />' BILL TO JOB SITE <br /> Af)V.e'',NC ,b MaO 11f' 1; <br /> :.a` OCKTON, CA ] b '�t�1Yi[,�`���, t A r3"�-) 1 '' <br />' Phone Customer P O Payment Terms 1=PA# <br /> 0- r 0 t1,b <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 /> lillilliliCYCI ANTIFREEZE N/A <br /> ON HAZARDOUS WASTE LIQUID -_, } <br /> TRUCK TIME N/A <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 p <br /> 1000 PPM total halides,or container any PC B's TO�.R► <br />' DRIVER GENERATOR/AUTHORIZED 1 ``j - <br /> SIGNATURE r SIGNATURE SIGNATURE ; „'� L <br /> TERMS INVOICES AVER 30 DAYS ARE SUBJECT TO A 1 5% 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 ! a <br /> r <br />' Driver signedI3 Date f f Generator signed t Date <br /> ::oi _t ., _ <br /> By signing the invoice the generator certifies that the generator has established a program to reduce the volume or quantity and toxicity of the hazardous <br /> ste to the degree, as determined by the generator,to be economically practicable <br /> 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 />' gat 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 4 CAD044003556 <br /> MPC(10/2004 <br />