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,(mi HF1C N VALUE 1,12657 <br /> WASTE ll! L9 8NG. Invoice Number: <br /> P. O. Box 340 o Delhi, CA 953'15 <br /> 1� 2 2M X 209-668-3880 <br /> R �-�- ` .. A__ 878 y <br /> BILL TO: <br /> FARMINGTON FRESH FEB 0 6 2017 •IDB SIl'I•lE;:FARMINGTON FRESH Invoi a Date: <br /> RO BOX 30667 7735 FRONTAGE 99 RD WEST <br /> STOCICfON,CA 95213 STOCKTON,CA 95215 <br /> ENVIRONMENTAL HEALTH X:ARCH <br /> 1-6 rK 416 -7bikli I DEPARTMENT Sales Rap; <br /> Phone Customer P.O. Terms EPA# <br /> 209-983-9700 JIM CAL-000289855 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used OIVMixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oilrm 126 c-y� <br /> J �✓ r <br /> NON Hazardous Waste Liquid G <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 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL .�V <br /> becomes necessary to collect this invoice. <br /> By siggning I herby certify that I have not mixed this waste with any other waste,that the total halides are less than 1000 P.P.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 /> 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 /> Amercan Valley Waste Oil hereby advises the above Ganeralor the Gen ora Is shipment of used oil lnay be transported to a facility that is required to comply <br /> with federal regulations applicable to management of uSad oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waste management tacllltiea.California facilities that handle or process used oil are reqquired to mast those more stdngent requirements,and some out-of- <br /> state fecllltlea that process used oil also meet those requirements, engineering certifications of tank Integrity, and financial assurances for closure and <br /> accidental rale.....It Is lawful to sand used oil to out-of-state facuh".that comply only with fed.ml used oil management standards and not these more <br /> stringent requirements. <br /> This notilication Is for Information purposes only. <br /> � - , GENERATOR/ <br /> AN E <br /> SIGNATOR DATSIGNATURE: ` C <br /> - <br /> O NAME: <br /> DISPOSAL/ RECYCLING FACILITY <br /> ADDRESS: /v DK-DIXON 0 RAMOS ENVIRONMENTAL SERVICE <br /> CITY/ST: /06-17300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> DIXON,CA 95620 W.SACRAMENTO,CA 95691 <br /> PHONE: 707.693-6008 <br /> 918-371-5747 <br /> EPAC EPA#CAT080012602 EPA#CAD044003556 <br /> MPC(42010) <br />