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AMERICAN VALLEY a 14 <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 /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> VVII-SON' Y TRE VVIII.bON VVAY I IRE <br /> 113.3 vv. 'i i,Ft ar 11'x:3 W. I 1TV! T <br /> TRACY, 9537( 'FRACY, CA 95370 <br /> Phone Customer P.O. Payment Terms -Z <br /> Itz! t <br /> PRODUCT SHIPPING DE'CRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZAROUS <br /> WASTE LIQUID 221 <br /> USED AUTOMOTIVE ANTIFREE, NON <br /> RCRA HAZARDOUS WASTE LIVUID 343 <br /> OILY WATER, NON RCRA HAZtRDOUS <br /> WASTE LIQUID 221 <br /> TRINITY HEAVY DUTY PREMIJ <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQ ID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> I hereby certify that I have not mixed this Naste with any other waste,that the total halides are less than 1000 P.P.M.;and that <br /> the waste does not contain any P.C.B.'s.I further agree to accept the additional charges for legal disposal if this waste is over <br /> 1000 P.P.M.total halides,or containes an�P.C.B.'s. TOTAL <br /> DRIVER GENERATOR/SIGNATURE AUTHORIZED <br /> SIGNATURE SIGNATURE <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE.CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br /> COURT ACTION BECOMES NECE SARY TO COLLECT THIS INVOICE. <br /> American Valley Waste Oil hereby advise 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 mal agement of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waste management facilities. California f cilities that handle or process used oil are required to meet those more stringent requirements, and some oot-of- <br /> state facilities that process used oil als meet those requirements, engineering certifications of tank integrity, and financial assurances for closure and <br /> accidental releases. It is lawful to send sed 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 purpos s only. <br /> Driver signed Date Generator signed Date <br /> By signing the invoice the generator cerifies that the generator has established a program to reduce the volume or quantity and toxicity of the hazardous <br /> to <br /> waste to the degree, as determined by t e generator, C 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 /> that their waste has been transported to i license treatment or transfer facility. <br /> DISPOSAL/ RECYCLING FACILITY <br /> 0 RIVERBANK OIL TRANJER 0 RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD- R VERBANK, CA 95367 1515 SOUTH RIVER ROAD-W. SACRAMENTO,CA 95691 <br /> 209-863-8181 - EPA 4 L000190816 916-371-5747- EPA#CAD044003556 <br /> MPC(1012004 <br />