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AMERICAN VALLEY 3 7 3 10J O <br /> r <br /> `RECYCLES 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 /> 1i i t <br /> ��T <br /> 1 f <br /> rf t l r v k <br /> Phone Customer PO Payment Terms EPA# <br /> '71"1C4 F"IR *1"'A %-f '�L) 4 + tiro <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <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 50150 <br /> YCLED ANTIFREEZE NIA <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME NIA <br /> GREASWEEP NIA <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5%SERVICE CHARGE CUSTOMER AGREES r TO PAY ALL LEGAL FEES IF COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE TOTAL <br /> DRIVER _ l GENERATOR - �- <br /> SIGNATURE/�� --�I SIGNATURE - r <br /> American Valley Waste Oil hereby advises the above Genera or 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, engmeering certifications of tank Integrity, and financial assurances for closure and acct <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 informationosep ur only <br /> _ _ <br /> p P Y <br /> Driver signed- ,r:z' „J I �/ Date ~i ~ :� Generator signed F Date ' <br /> By signing the invoice the berierataf certifids that the generator has established a program to reduce the volume 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 /> it waste has been transported to a license treatment or transfer facility RECEIVED <br /> DISPOSAL/ RECYCLING FACILITY 1 <br /> O RIVERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES OCT 2 5 1003 <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 4 CAD044003556 <br /> MPC(4/2003) <br />