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AMI"RICAN VALLEY <br /> WASTE ®IL, INC. Invoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> I3II,1 TO: JOB SITE: 111 uice Dale: <br /> O.G PACKING O.G PACIQNG <br /> 2097 BEYER LN 2097 BEYER LN. <br /> STOCKTON,CA 95205 STOGKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> Phone I Customer P.O. Terms EPA# <br /> 2.09-931-4392 DAVE I Net 30 Bays I CAL000267628 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST (QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 2211 >> �: �_ I "� O <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 /> TERMS: Invoices over 30 Days are subject to a 1.59.service charge. Customer agrees to pay all legal fees if court action TOTAL r <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have not mixed this waste with any other waste, that the total halides are less than 1000 RP.M;and that the waste does not <br /> contain any P.C.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 /> Generators Certification: By signing 1 certify that I 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 Vallcy 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 ofd-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 /> GENERATOR' <br /> DRIVER � a", /l AUTHORIZED % /, <br /> SIGNATURE: DATE: C`" ' SIGNATURE-.,k DATE: li <br /> O NAME: - - - - DISPOSAL /' RECYCLING FACILITY <br /> ;ADDRESS. __ O DK-DIXON <br /> O RAMOS ENVIRONMENTAL SERVICE <br /> CITY/Sl.- 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 at CAT080012602 EPA # CAD044003556 <br /> a,tr c t.azuto> <br />