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AMERICAN VALLEY 65802 <br /> WASTE OIL, .INC. Invoice Number: <br /> P. O. Box 340 • Delh, CA 95315 <br /> PH. 1-800.732-4645; • FAX 209-668-3880 <br /> EPA. CA0000827878 <br /> 9- -)0 - 0 <br /> Invoice Date: <br /> BILI.TO: �iu iiril�iv r ie7 t itii-j;Aik JOB SITE: <br /> Ypfl.g7 W YtIS Eft1NTf �-�IUZIIVIIAIN AU 10 PE-PiqR <br /> '11711? %A/ YfscIMITP <br /> ..,. X. Nlf,,N <br /> t' M'4 I k:r..:Ai, L:Ft 9:)jj1 <br /> Phone <br /> Customer P.O. Payment Terms EPA# <br /> dLl;7-.;,J!,� i.ti:d 4rU4i'?IH r,.11_1I_j . r�l.rsr?f rl n.rr r-,r <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 <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> cr• 4 •. <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 ' rJ <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 contalnes an P.C.B.,s. ....:_, TOTAL <br /> DRIVER / GENERATOR AUTHORIZED <br /> t <br /> SIGNATURE .�'' - .+f''`"� SIGNATURE/ <br /> � f,5'1. � ,�� <br /> —'- SIGNATURE/SIGNATURE <br /> TERMS: INVOICES OVER 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 oll 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 /> ` 1 <br /> This notification is for If <br /> inf rte' purposes"only l .^ ( (� f (� <br /> Driver signed `^M"''` no <br /> ata „� } j ._' t, <br /> By signing the i e the generator c 1Qifie�$ at the generator has e a hs ed a proogr mo reduce the volume or quantity and toxic ty 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 I RECYCLING FACILITY <br /> O•RIt!�NBANK 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(1=00<) <br />