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AAMERI NVALLEY 49542 <br /> WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> / <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> /) EPA. CAL000827878 <br /> BILL TO: �' � /i� �,' Invoice Date: <br /> JOB SITE: <br /> ,IJZ'MAN AUTO REFATR ,UZMAPJ ,AUTO REPAIR <br /> 3.037 W. YOSF,MITE 1037 W. YC:STMITF. <br /> MANTECA, CA 95331 .,: r_RdION <br /> MANTECA, CA 953.37 <br /> Phone Customer P.O. Payment Terms EPA# <br /> ,. <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> USED OIL NON RCRA HAZARDOUS CODE <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 /> G REAS W EEP N/A <br /> I hereby certify that I have nat mixed this waste with any other waste,that the total halides are less than 1000 P.P.M.;and the 11 <br /> the waste does not corrtain any P.C.B.'s.1 fud. r agree to accept the additional charges for legal dispose)ff this waste Is over <br /> 1000 P.P.M.total helloes,or con Ines a P.-C.e.,a. .. 1 TOTAL <br /> DRIVER f N „M°' i'` GENERATOR/AUTHORIZED <br /> SIGNATURE iG_ ..-.._...... <br /> - SIGNATURE SIGNATURE ---- <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE,CUSTOMER AGR3"lb 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 all 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 hazardou <br /> waste management facilities.California facilities that handle or process used oil are required to meet those more stringent requirements,end some oui-af- <br /> s <br /> state facilities that process used oil also most 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 info;Oon QUrposes,.ertfy. 't , <br /> Driver signed Date 'CJ R' <br /> By signing the7"nvbfce e- Generator signed - Date , <br /> �sminedr yiFffi ies Chet the generator has established a program to reduce the )unto or quantity end toxicity of the h <br /> waste h the degree, g determined by the generator, to be economically practicable. 84 ! <br /> By both parties signing this invoice it wi11 setve as an agreement that American Valley will submit confirmations for(certain waste streams e <br /> that their waste has been transported to a license tfeatment or transfer facility. <br /> *l . <br /> DISPOSAL / RECYCLING FACILITY <br /> --, VERBANK 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 It CAD044003556 <br /> ..-___. MPC(102004) <br />