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AMERICAN VALLEY 99562 <br />WASTE OIL, INC. Invoice Number: <br />P. O. Box 340 • Delhi, CA 95315 <br />PH -11-800-732-4645 • FAX 209-1568-3880 <br />CAL000827878 <br />BILL TO: JOB SITE: C� <br />/,Itf--t-- n v o i c e Date: <br />Phony n.. <br />I terms EPA# —� <br />V r' <br />—CRIP-T-ION <br />PRODUCT SHI PING D <br />WASTE MANIFEST QUA ITY PRICE AMOUNT <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />Q 3-1 <br />-, �' ?j C-11 <br />Z, <br />?j C v <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />I <br />NON RCRA Waste Liquid Used Oily Water <br />_ <br />(Jll <br />v <br />NON Hazardous Waste Liquid <br />Trinity Heavy Duty premixed Antifreeze <br />Trinity Extended Life premixed Antifreeze <br />1 <br />Trinity Case Goods <br />- - - ---- ------ _ --- <br />Truck Wash Out <br />Truck Time <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. Customer agrees to pay all legal fees if court action TOTAL <br />becomes necessary to collect this invoice. _ <br />By signing I herby certify that I have not m xed this waste with any other waste, that the total halides are less than 1000 PPM; aria mat the waste does not <br />contain any P.C.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 PPM. total halides, or contains any PC B's <br />I <br />Generator's Certification: By signing I certify that I have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree I <br />have determined to be economically practicable. <br />By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the <br />generator that their waste has been transported to a licensed treatment or transfer facility <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 />G NERATOR, <br />DRIVER gf THORIZED <br />SIGNATURE: DAT E. -Z -/ �/� � <br />SIGNATURE: 1 �Aez DATE <br />� b^ <br />O NAME ------.._.-- DISPOSAL/ RECYCLING FACILITY <br />ADDRESS. - —G-T5K-DIXON O RAMOS ENVIRONMENTAL SERVICE <br />CITY/ST: 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br />DIXON, CA 95620 W. SACRAMENTO. CA 95691 <br />PHONE: _ _ 707-693-6008 916-371-5747 <br />EPAC EPA X CAT080012602 EPA a CAD044003556 <br />MPC (42410) <br />