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AMERICAN VALLEY <br /> EcYCLE WASTE OIL, INC. Invoice Number <br /> I 4' P O Box 340 - Delhi, CA 95315 <br /> PH 1-800-732-4645 - FAX 209-668-3880 <br /> EPA CAL000827878 <br /> Invoice Date <br /> I BILL TO: JOB SITE: <br /> t <br /> 75, <br />' Phone <br /> Customer PO Payment Terms EPA#,._, <br /> I 6 <br /> 2"i�7 4-1: i <br /> � ���•�� J° LTJ Ar 'V r°t `.3 <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 /> W <br /> ITY HEAVY DUTY 50/50 <br /> YCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID Y _ , ` < < <f ;"�,- 4:`1� <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5%SERVICE CHARGE CUSTOMER AGREES1 <br /> TO PAY ALL LEGAL FEES IF COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE TOTAL <br /> DRIVER GENERATOR <br /> SIGNATURE SIGNATURE <br /> IAmerican 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, engineenng 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 r <br /> This notification is for inforrrsation purposes only .� Y <br /> Driver signed ' T Date Generator signed ` ��"� �" Date <br /> I By signing the invoice the generator certifies 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 /> 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 /> I <br /> DISPOSAL / RECYCLING FACILITY <br /> RIVERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W SACRAMENTO, CA 95691 <br /> I 209-863-8181 - EPA# CAL000190816 916-371-5747•EPA#CAD044003556 <br /> MPC(4/2063) <br />