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AMERICAN VALLEY 112657 <br /> WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 a Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> BHA,TO:FARMINGTON FRESH JOB SITE:FARMINGTON FRESH Invoi a Date: <br /> P.O BOX 30667 7735 FRONTAGE 99 RD WEST <br /> STOCKTON,CA 95213 STOCKTON,CA 95215 <br /> X ARCH <br /> -V;631 Sales Rep: <br /> Phoner P-O. Terms ` EPA# <br /> Custome <br /> 209-983-9700 JIM CAL000289855 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used 01V ear -226 (V 5-0 <br /> NON Hazardous Waste Liquid J <br /> � 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 Deys are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL .e�-- <br /> becomes necesse t0 collect this Invoice. <br /> By siggning I her byy 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.N. 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 thp.volitme 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 shove Generator the Generators shipment of used oil inay be transported to a facility that is required to comply <br /> with federal regulations appl�ab1 to managgement of used ell,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waste management fac11Niea. California fee Titles that handle or Procoss used ell are required to meat those more stdnggant requirements,and some out•oi- <br /> state terilitiea that process used oil also mast those requirements, onginooring cer6hcatbna of tank Integrity, and Onancial assurances for closure and <br /> ecridantal raises...It ie lawful to send used oil to out-of-state faeilltiss,hof comply only with federal used ell management standards and not these more <br /> stringent requirements. <br /> This notification Is for information purposes only. r <br /> GENERA <br /> DRIVER ��/g6 <br /> _� AUTHORIZED <br /> DAfE:/ <br /> SIGNATOR pA7 <br /> i y <br /> O NAME: _ a ECY LING FACILITY <br /> ADDRESS:_ DK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> n <br /> CITY/ST: �F ,P _ a <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> DIXON,CA 95620 W.SACRAMENTO,CA 95691 <br /> PHONE: 707-693-6000 <br /> 916371.5747 <br /> EPAC Ent\"' '— - -._„EfM CAT080012602 EPA 9 CAD044003556 <br /> MPC(42010) <br />