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r --- <br /> a AMERICAN VALLEY 97562 <br /> WASTE IL, INC. Invoice Number: <br /> R 0.Box 340 • Delhi,CA 95315 <br /> PH. 1-800-732-4645 9 FAX 209-668-3880 <br /> CAL600827878 <br /> BILL TO: JOB SITE:FSH CONSTRUCTION <br /> a Date: <br /> F$H CONSTRUCTION 4945 WATERLOO <br /> 4945 E.WATERLOO RD 4945 WAIN L 9x205 <br /> STOCKTON,CA 95215 <br /> Qslga RAD St <br /> Phone Customer P.O. Terms EPA# <br /> 209-931-373 ENE Net 15 Days CA_I0006113968 <br /> PRODUCT SHIPPI7LIquid <br /> CRIPTION EWA MANIFEST QUANTITY NT <br /> NON-RCRA Waste Used Oil/Mixed Oils r� �. (j NON-RCRA Waste Used Antifreeze <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Antifreeze <br /> iity Extended Life premixed Antifreeze <br /> Ay Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subject to a 1.50/6 service charge. Customer agrees to pay all legal fees If court action TOTAL `�j CC/ <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have not mixed this waste with any other waste,that the total halides are less than 1000 RP.M;and that the%6stedoesB�t <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 contalnAnV . <br /> Generators Certification: By signing t certify that I have a program in place to reduce the volume and toxicity of hazardous waste generated to tiie degr@e'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 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 oilbut 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 strinand figant requirements,and some out-of- <br /> accor closure and <br /> statidentafacilities <br /> releases.It Is lawful to send t process used oil sused oil o out-of-state o meet those facilitiesrequirements, <br /> comply onlyatwith federal used ions of lank oil man gementistandards and al assurances fnot these more <br /> stringent requirements. <br /> This notification Is for information purposes only. <br /> GENERATOR! <br /> DRIVER /� / AUTHORIZED /• / , DATF�r�? (% J <br /> SIGNATURE////// / DATE: SIGNATURE: <br /> 0 <br /> NAME: DISPOSAL/ RECYCLING FACILITY <br /> ADDRESS: �DK-DIXON 0 RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> CITY/ST: DIXON,CA 95620 W.SACRAMENTO,CA 95691 <br /> PHONE: 707-693.6008 916-371-5747 <br /> EPA#CAT080012602 EPA#CAD044003556 <br /> EPA@: <br /> MPC(4/2010) <br />