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W <br /> AMERICAN VALLF <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 /> 7 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> ADWt AJNCETD GIE0 <br /> R.�7 -ZR 1�1 Z' 1,856 "'OUNTRY CLUS BL�Ie7D <br /> C'A <br /> Ss!ez.kep <br /> Phone Customer P.O. Payment Terms EPA4 <br /> 4 <br /> 2 1 1 <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 /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID (y <br /> d <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> Uf 1.C'S ?N tC-Li 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 P.C.B.'s. I further agree to accept the additional charges for legal disposal if this waste is over <br /> 1000 P.P.M.total halides,or containesany P.C.B.'s. TQTAL <br /> DRIVER K SIGNATURE GENERATOR/SIGNATURE <br /> AUTHORIZEV. <br /> SIGNATUREE,,, <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE, CUSTdIVIER 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 /> nri\­6nneri nnt". Generator sinned Date <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 /> waste to the degree,as determined 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 /> 0 RIVERBANK OIL TRANSFER 0 RAM08 ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD* RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD-W. SACRAMENTO, CA 95691 <br /> 209-863-8181 -EPA#CAL0001 90816 916-371-5747-EPA#CAD044003556 <br /> ew mP6 f.1 mon <br />