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AMgMAN VALLE`" 62065 <br /> WASTE OIL, INC. Invoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> /rPH. 1-800-732.4645 • FAX 209-668-3680 <br /> EPA. CAL000827878 <br /> Invoice Dat 4 <br /> BILL TO: ;;LWMAN AUTO REPAIR JOB SITE: GUZJ10AN AUTO REPA R <br /> 1037M1 YOSFAAIT'F 10147W YOS;IMIT'E <br /> MANTECA, CA g5337 X: UNION <br /> MAINI F-GA, (`A 96331 <br /> 1 a k,&rep, RicK(:laniel <br /> Phone Customer P.O. Payment Terms - EPAfk <br /> - <br /> :'U..i s,+.:13 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MAMF-STS QUANTITY _PACE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 ?- 4/ 7/ <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 q N/A yr„ <br /> GREASWEEP N/A <br /> FUEL SUP. CHARGE � $5.00 <br /> 1 hereby certify that I have not mixed this waste with any other wasta,that the total halides are less then 1000 P.P.M.;and that <br /> the waste does riot contain any P.C.B.'s. I further agree to accept the additional charges for legal disposal if this waste,11%over OTAL <br /> 1000 P.P.M.total halides,or contalnes an P.C.B.'s. / <br /> DRIVER GENERATOR/AUTHORIZED <br /> SIGNATURE SIGNATURE SIGNATURE <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE. CUSTOMER AGREES-TlS 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 lntegrrty, and financi 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 managers standards end not these more <br /> stringent requirements. <br /> This notification Is for information purposes only. � <br /> Driver signed / Date-? � . - Generatorsigned Date_'__�_. � <br /> By signing the invo�the generator certifies that the generator has established a program to r the volume or quantity and tDate of eth hezerdotis <br /> waste to the degree,as aetermined by the generator,to be economically practicable. <br /> By both parties signing this invoice It will serve as an agreement that Amerl�pan 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 /> _ <br /> -DISPOSAL / RECYCLING FACILITY <br /> Cr_RIVERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD•RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO,CA 95691 <br /> 209-883-8181 •EPA k CAL000190816 16.371-5747• EPA k CAD044003556 <br /> MPC noaW4) <br />