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AMERICAN VALLEY 57070 <br /> WASTE OIL, INC. - Invoice Number: <br /> P. 0. Bax 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668.3880 <br /> EPA. CAL000827878 <br /> nvoice Date: <br /> BILL TO: JOB SITE: <br /> CU74MAN AUTO REPAIR GUZMAN AUTO REPAIR <br /> 1037 W. YOSEMITE 1.037 W. Y05FBITE <br /> MANTECAr CA 95337 MANTFX,-At CA 95:337 <br /> Phone c Customer P.O. Payment Terms sainaRep <br /> 9•-239-2819 MARIA WASTE C:. 0. Il. GALO 0244551 <br /> PRODUCT SHIPPING DESCRIPTION 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 r <br /> GREASWEEP N/A <br /> (h <br /> I hereby certify that I have not mixed4his waste with any other waste,that the total halides are less than 1 P.P.M.;and that r^s <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. 's. TOTAL is <br /> DRIVERGENERATOR/AUTHORIZED <br /> SIGNATURE = ' r '' --' 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 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.Ceilfomla 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-cf-state facBltles that comply only with federal used oil management standards and not these more <br /> stringent requirements. <br /> This notification Is fgFanbrr ation p se "a'ilye t", <br /> Driver signed ff 1t.^^'-..�+^ �, "i ., .,:2;' ! r r <br /> , =Date �,,,2Generetor signed ' .�.^ t� Date [ 1 <br /> By signing the 46vdke if soars or CePI es that the generelor has established a program tar u e the velums or quantity M 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 confirmation$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 /> -. vERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> . %00 CLAUS ROAD•RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO, CA 95691 <br /> 209-883.8181 •EPA k CALoo0190a18 918-371-5747• EPA p CAD044003566 <br /> MPC(10,2004) <br />