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AMERICAN VALLEY 65802 <br /> WASTE OIL, INC. Invoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645' • FAX 209-668-3880 <br /> EPA. CAL'000627676 <br /> Invoice Date: <br /> BILL TO: (aiurviF)fd .e u i.,EP'AiR JOB SITE: r- <br /> +at.GlmrV HiJ I'0 REr°tuk <br /> tlY37 VV YO,';FMITFr 1t7:1';r w Yr).c;MITF <br /> Pd1ANTIE;A, -^A V. UNION <br /> I'AA41 Lwt,A, UA Vasey <br /> •XY MJ.y)4}U <br /> Phone Customer P.O. Payment Terms EPA# <br /> fi''iAkiA <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 /> Z. <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> ', M <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 <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 o <br /> 1000 Rver TOTAL <br /> P.M.total halides,or container an P.C.B.'s <br /> . .-+•••, <br /> DRIVER f j GENERATOR/AUTHORIZED <br /> SIGNATURE ` SIGNATURE SIGNATURE J <br /> TERMS: INVOICES OVER 3 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.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 int rffatl' purix spy�only rr f / ( <br /> f' /, „,e'Y {.+ " g ,� ..IJ` �_. )) J D®te (" 't �,..I f... . <br /> Driver signed .wer �,,�^Uate stator si ned <br /> By signing the i the generator clartifias"CFat the generator has e!2tllished a program to reduce the volume or quantity and 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 confirmations for(certain waste streams)to the generator <br /> that their waste has been transported to a license treatment of transfer faicfiity. <br /> D}SPOSAL/ RECYCLING FACILITY <br /> O4tIl6BANKOIL 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(10.'2004) <br />