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' AME RICAN VALLEY 9 9 1.61 <br /> WASTE OIL, INC. Invoice Numbei <br /> 1 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 /> Advo o eco �e,D 1 U e 5--6 Cry <br /> ';(?-�>-1 Sho-w Kt 04b E , Ho I t1A <br /> vatbo I <br /> ' Phone Customer PO Payment Terms EPA# <br /> 4 - el <br /> ' PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> ' ED 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 /> ' ECYCLED ANTIFREEZE NIA <br /> N HAZARDOUS WASTE LIQUID <br /> ' TRUCK TIME NIA <br /> GREASWEEP NIA <br /> 1 <br /> ' I hereby certify that I have not mixed Iters waste with any other waste,that the total halides are less than 1000 P P M.and that <br /> the wasto docs not contain any PSC 8's I further agree to accept the additional 0arges for lsya6 disposal it this waste is over TOTAL <br /> P PM total halxfes,or i ontaines any PC 11'S <br /> ' SNTGENERATOR/ <br /> SUNO �U <br /> SIGNATURE V / SIGNATURE <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5%SERVICE CHARGE CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br /> COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE <br /> American Valley Waste Oil hereby advises tho above Generator the Generators shipment of usod oil may be transported to a facility that is required to comply <br /> with federal regulations applicable to managerrrent of used all,but that is not required to comply with the more stringent requirements applicat4e to Wz&rdous <br /> waste management facilities Callfomia faclllt"that handle or prows used oil are required to moat those more sinngent requirements, and some out-of- <br /> stale facilities that process used oil also meet those requirements, ongrneenng certifications of tank tntegr€ty, and financial assurances toe Closure and <br /> accidental releases It is lawful to send used oil to out-ol-state facilities that comply only with federal used oil management.standards and not these more <br /> stringent requirements <br /> This ncWicat€on is for infommtron purposes only .� <br />' Onver s€gned_,. � lute - ; _ Generator signed <br /> By signing tris inva the generator certifies that the generator has established a program to redu(e the volume or quantity and toxicity of the hazardous <br /> waste to the degree,as determined by the genorator,to be econoin[oaliy practicable <br /> y both parties signing this invoaoe it will serve as an agreement that American Valley will submit confirmations for(certain waste streams)Iv the generator <br /> 1 their waste has been transported to a license treatment nr trariest"facility <br />' <br /> DISPOSAL/ RECYCLING FACILITY <br /> „RIVdER13 ANK OIL TRANSFER 0 RAMOUS ENVIRONMENTAL SERVICES <br />' 5300 CLAUS ROAD*RIVERBANK,CA 95367 1515 SOUTH RIVER ROAD•W SACAAMENTO,CA 15981 <br /> 209-863-6181 •EPA#CALOOO1190816 916-371-5747•EPA#CAD044003556 <br /> i�PC ii412Ui <br />