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AMERICAN VALLEY <br /> WASTE OIL, INC. (nvoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> ►>II.L 'I'O: JOl3 SI'C1;: Invoice Date: <br /> Phone Customer P.O. Terns EPA# <br /> i <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST IOUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 j <br /> NON-RCRA Waste Liquid Used Antifreeze 133 I— -- <br /> NON-RCRA Waste Liquid Used Oily Water 2237- 7 <br /> - -- —— <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 1.5110 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 I have not mixed this waste with any other waste.that the total halides are less than 1000 RRM: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 /> Generator's Certification: By signing I 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 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-ol- <br /> state facilities that process used oil also meet those requirements, engineering certifications of lank 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 /> GENERATOR' <br /> DRIVER AUTHORIZED - <br /> SlGfJATURE: DATE' SIGNATURE: DATE: , <br /> I <br /> O NAME - --- - - - - - DISPOSAL / RECYCLING FACILITY <br /> ADDRFc,S_— _-- _ —_ O DK-DIXON <br /> O RAMOS ENVIRONMENTAL SERVICE <br /> CITY:;T 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> -- -- ---- DIXON, CA 95620 W.SACRAMENTO, CA 95691 <br /> PHONE. 707-693-6008 916-371-5747 <br /> EPP: EPA#CAT080012602 EPA# CAD044003556 <br /> t4pc 1.1120101 <br />