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.AMERICAN VALLEY 63431 <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 /> ttf 6 �{ s� <br /> Invoice Date: <br /> BILL TO: JOB SITE: A � <br /> / 09y <br /> Phone Customer P.O. Payment Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS j + i <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 /> I Mreby certify that I have not mixed this waste with ap 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 a7de to accept the additional charges for legal disposal if this waste is over TOTAL <br /> 1000 P.P.M.total halides,or conte nes an RP-13:1. <br /> DRIVER GENERATOR AUTHORIZED <br /> SIGNATURE �� -.--•- SIGNATURE/SIGNATURE ( ` <br /> TERMS: INVOICE OVE9,10 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE. CUSTOMER AGREES TO PAY ALL tEGAL 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 informatign purposes only. _ ! <br /> L r � <br /> Driver signed �/� �-"Date `�'; - �enRrator signed�f.'� 1 date <br /> By signing the invoil �g.#e erYerator ce les that the ge ato hhes establlk§had a program to reduce the volume or quantitg nd tox!Q*of the hazardous <br /> waste to the degrg9;`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 faculty. <br /> DISPOSAL/ RECYCLING FACILITY <br /> 5IVERBANKOIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO, CA 95691 <br /> 209.863-8181 •EPA#CAL000190816 916371-5747•EPA#CAD044003556 <br /> MPC(1(V2004) <br />