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AMERICAN VALLEY 7 "", ~_ WASTE ®IL, INC. Invoice Number: P.O. Box 340 • Delhi, CA 95315 PH. 1-800-732-4645 • FAX 209-668-3880 EPA. CAL000827878 Invoice Date: HILI;TO: O.G PACKING .1013 SITE: 0-0 PAWING 2097 REFER LN 2097 BEYER LN, STOCK`I , OA O �'T 'FOCK TC , CA 95205 rpt til�m, P§�1-4392DAVECustomer P.O. Payr� c' ert? 4% EPA1 `� PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT CODE USED OIL NON RCRA HAZARDOUS WASTE LIQUID 221 i USED AUTOMOTIVE ANTIFREEZE, NON RCRA HAZARDOUS WASTE LIQUID 343 _ -__—......_......._--._.__..__._ ._-._._.. __......_...................._.._.-.._.- — OILY WATER, NON RCRA HAZARDOUS WASTE LIQUID _ 221 TRINITY HEAVY DUTY PREMIX RECYCLED ANTIFREEZE N/A I NON HAZARDOUS WASTE LIQUID TRUCK TIME N/A GREASWEEP N/A fnpriy = Jed I Prf-,ressx r led Antilii r,z', I hereby certify that I have not mixed this waste with any other waste,that the total halides are less than 1000 PPM.;and that the waste does not contain any RC.i3:s.I further agree to accept the additional charges for legal disposal if this waste is over TOTAL. 1000 PP.M.total halides,or containes any P.C.(3a. DRIVER GENERATOR/AUTHORIZED SIGNATURE r . `f SIGNATURE f SIGNATURE _...-- - _ _ T._`.–..____.._..__..........._...................................._.._..._._.._..__._-. TERMS:INVOICES OVER 30 DAYS ARE SUBJECT TO A1.5%SERVICE CHARGE.CUSTOMER AGREES"TO PAY ALL LEGAL FEES IF COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. 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 with federal regulations applicable to management of used oil.but that is not required to comply with the more stringent requirements applicable to hazardous waste management facilities.California facilities that handle or process used oil are required to meet those rnore stringent requirements,and some out-of- state facilities that process used oil also meet those requirements, engineering certifications of tank igwgrity, and financial assurances for closure and 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 stringent requirements. This notification is tor 00orrnation purposes Only. r Driver signed ._—._.Date, Generator signed �._. _......_.. —---------- -Date By signing the invoice the generator certifies that the generator has established a program to reduce the volume or quantity and toxicity of the hazardous waste to the degree,as determined by the generator,to be economically practicable. 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 that their waste has been transported to a license treatment or transfer facility. DISPOSAL / RECYCLING FACILITY 0 DK-DIXON O RAMOS ENVIRONMENTAL SERVICES 7300 CHEVRON WAY•DIXON,CA 95620 1515 SOUTH RIVER ROAD•W.SACRAMENTO, CA 95691 800-727-2879•EPA k CAT080012602 916-371-5747•EPA it CAD044003556 MPC torrzoo<r