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AMERICAN VALLEY 521602 <br />' <br /> WASTE IL, INC. Invoice Numbei <br /> OIL, <br />' P O Box 340 - Delhi, CA 95315 <br /> PH 1-800-732-4645 - FAX 209-668-3880 <br /> EPA CAL000827878 <br /> Invoice Date <br /> BILL TO: JOB SITE: <br /> 13 ffi�t 11.1 zsA7*Rrr alpP} <br /> 'jA !3"2 J ty t"�i kf ltt 1 <br /> ' Phone Customer PO Payment Terms EPA# <br /> r <br /> ' PRODUCT SHIPPING DESCRIPTION WASTE MA,NIF�ST QUANTITY PRICE AMOUNT <br /> CODE s <br /> USED OIL NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> ' OILY WATER, NON RCRA HAZARDOUS ' <br /> WASTE LIQUID 221 �- <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE NIA <br /> ' HAZARDOUS WASTE LIQUID <br /> ' TRUCK TIME NIA <br /> GREASWEEP NIA <br /> 1 <br /> ' 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 <br /> the waste does not contain any PC B's I further agree to accept the additional charges for legal disposal if this�a�"-s <br /> over ��� 4, , <br /> 1000 P P M total hail s,or con Ines an PC 8's 1 <br /> DRIVER GENERATOR AUTHORIZE , <br /> SIGNATURE ' _ ----- SIGNATURE/ SIGNATURE i <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5%SERVICE CHARGE CUSTO ER AGREES TOCP Y A L LEGAL FEES IF <br /> COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE {t t <br /> American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may be transported to a facility thatis 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 jl5phcable 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 ass6rances 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 signed Date Generator signed Date <br /> ' 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 <br /> waste to the degree,as determined by the generator,to be economically practicable <br /> oth parties signing this invoice it will serve as an agreement that American Valley will submit confirmations for(certain waste streams)to the generator <br /> oheir waste has been transported to a license treatment or transfer facility <br /> ' DISPOSAL/ RECYCLING FACILITY <br /> Q RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD- RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W SACRAMENTO,CA 95691 <br /> ' 209-863-8181 -EPA#CAL000190816 915-371-5747- EPA#CAD044003558 <br /> MPC(I W2004 <br />