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02/28/2011 11:48 FAX 0007 <br /> AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice Number: <br /> P. 0. Box 340 * Delhi, CA 95315 <br /> , 257.L <br /> PH_ 1-800-732-4645 - FAX 209-658-3880 <br /> EPA. CAL000827878 <br /> Iiivoi6e Date: <br /> BILL TO: JOB SITE: <br /> 7 Z L <br /> 5 S <br /> Phone Customer P.O. Payment Terms =iEPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 .3 <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILYWATER, NON RCRA HAZARDOUS <br /> WAST.E 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 /> LA'a <br /> I hereby certify that I have not mixed this waste with any other waste,that the Lotal halides are less than 1000 P.P.m.;and that <br /> -'s. I.further agree to accepttheadditional criarges or legal disposal i.f this aste is over <br /> the waste does not contain any F.C.B f7w TOTAL <br /> 1000 P.P.M.total halides,or containes any P-C.B.'s. <br /> GENERATOR/AUTHOMZE& <br /> DRIVER SIGNATURE' <br /> SIGNATURE SIGNATURE I <br /> TERMS: INVOICES¢VER iO DAiS'AR—ESU13JECT 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 oill'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 6iI are required to moot those more stringent requirements, and 501TIG out-Of- <br /> state facilities that process Used Oil also <br /> meet those requirements, engineering Gortlficaftns of tank integrity, and financial assurances for closure and accidental releases, it is lawful to send used oil to out-of-state facilities that 0ornpiy only with tederal used oll.managament standards and not these more <br /> stringent requirements. <br /> .s.0rily. <br /> This notification is for informqWp p4.rpqi�e <br /> Date <br /> Date -Generator 5ignod <br /> signed �e ll "" / Iza�1 <br /> Drivers toxicity of the hAturclous <br /> By signing th;Tn_­vo`lcdAI1e g;rleratn cortieb that the generator has established a pirograrri to reduce the.�iolume or quantity and toxicity of <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 or transfer facility, <br /> DISPOSAL RECYCLING FACILITY <br /> bl=,RIVERBANK OIL TRANSPER 0 RAMOS ENVIRONMENTAL SERVICES <br /> $300 CLAUS ROAD -RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD-W. SACRAMENTO, CA 95691 <br /> 916-371�,5747-EPA#CAD044003556 <br /> 209-663-8181 -EPA 4 CAL0001190815 MPC(101-nof <br />