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AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> MU—TO: JOB SITE: Invoice Date: <br /> Phone Customer P.O. Terms EPA# <br /> i <br /> PRODUCT SHIPPING DESCF IPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid USE d Antifreeze 133 <br /> NON-RCRA Waste Liquid Us d Oily Water 223 <br /> NON Hazardous Waste Liqui <br /> Trinity Heavy Duty premixed Antifreeze <br /> Trinity Extended Life premixed ntifreeze <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 <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have of mixed this waste with any other waste,that the total halides are less than 1000 RRM,,and that the waste does not <br /> contain any PC.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 ill 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 tr nsported to a licensed treatment or transfer facility. <br /> American Valley Waste Oil hereby ad ises 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 r ianagement of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> 'waste management facilities.Californ a 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 <br /> accidental releases. It is lawful to sed used oil to out-of-state facilities that comply only with federal used oil management standards and not these more <br /> stringent requirements. <br /> This notification is for information purposes only. <br /> GENERATOR/ <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE: SIGNATURE: DATE: <br /> O NAME: DISPOSAL / RECYCLING FACILITY <br /> ADDRESS: O DK-DIXON O 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 />