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1 �k <br /> AMERICAN VALLEY 97893�? <br /> k '.. <br /> } WASTE OIL, INC. 3 Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> RECEIVED <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 JAN 18 2011 <br /> BILL TO: ��� � <br /> JIM THORPE Olt.INC JOB SITE:SPRECnES SUGAR PERM <br /> P.Q.BOX 357 20500 HOLLY DR <br /> LODI,CA 95241 TRACY,CA 95304 <br /> CAD981367741 <br /> PhoneSoo Pap.Steve <br /> Customer P.O. - Terms EPA#� <br /> 209.462-4581 Net 30 C?�tys <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Antifreeze <br /> Trinity Extended Life premixed Antifreeze <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> Y � <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action, TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that! have not mixed this waste with any other-waste,that the total halides are less than 1000 P.PM;and that the waste does not <br /> contain any RC.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 P.P.M.total halides,or contains any P.C.B's <br /> Generator's Certification: By signing I certify that 1 have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree I <br /> have determined to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the <br /> generator that their waste has been transported to a licensed treatment or transfer facility. <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 information purposes only. <br /> DRIVER f AUTHORIZED <br /> SIGNATURE: DATE y le r <br /> SIGNATUR � �7�� ATE; f �y <br /> O "AME: <br /> DISPOSAL / RECYCLING FACILITY <br /> ADDRESS: O DK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> CITY/ST; 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> DIXON, CA 95620 W.SACRAMENTO, CA 95691 <br /> PHONE: 707-693-6008 916-371-5747 <br /> EPA#: EPA#CAT080012602 EPA#CAD044003556 <br /> MPC(4120t0) <br />