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AMERICAN VALLEY <br /> r�rcvcLE WASTE OIL, INC. Invoice Number <br />' P O Box 340 • Delhi, CA 95315 <br /> • PH 1-800-732-4645 • FAX 209-668-3880 <br /> EPA CAL000827$7$ <br /> I <br /> Invoice Date <br /> BILL TO: JOB SITE: <br /> o j <br /> Phone Customer P O Payment Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> ICODE <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 /> 1NITY HEAVY DUTY 50/50 <br /> YCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A l <br /> GREASWEEP N/A <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5% SERVICE CHARGE CUSTOMER AGREES <br /> TO PAY ALL LEGAL FEES IF COURT ACTION BECOMES NECESSARY TO COLL ECT THIS INVOICE TOTAL <br /> IDRIVER GENERATOR _ <br /> SIGNATURE SIGNATURE <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 of- <br /> state facilities that process used oil also meet those requirements, engineering certifications of tank integrity,and financial assurances for closure and acci- <br /> dental 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 strin- <br /> gent requirements <br /> This notification is for information purposes only <br /> Driver signed Date Generator signed " ' c Date <br /> By signing the invoice the generator certifies that the generator has established a program to reduce the vorume or quantity and toxicity of the hazardous <br /> waste to the degree,as determined by the generator,to be economically practicable <br /> By both parties signing this invoice it will serve as an agreement that American Valley will submit confirmations for(certain waste streams) to the generator <br /> .their waste has been transported to a license treatment or transfer facility <br /> DISPOSAL/ RECYCLING FACILITY <br /> O RIVERBANK OILTRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W SACRAMENTO, CA 95691 <br /> 209-863-8181 • EPA#CAL000190816 916-371-5747•EPA#CAD044003556 <br /> MPC <br />