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06/01/2012 16:06 209948 25 ACMESAW PAGE 02 <br />AmERICAN VALLEY <br />, A <br />WASTE OIL, INC. hi'v'oIce" Nu'rnher: <br />P 0. Box 340 - Delhi, CA 95315 <br />PH, 1-800-732-4645 * FAX 209-668-3880 <br />CA L000827878 <br />BILL TO: JOB SITE: <br />ACM U ,.-A vv Ai. nig w4y;e Invoice Date: <br />F MAIN 12 4�4 s M r%ii�: <br />STOCK'tolq <br />Phone Customer RO, rKIM <br />EPA# <br />2W-946,6,13f� CiIANA .7 <br />]77 7 <br />PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br />NON-RCRA Waste Liquid Used Antifreeze 133 <br />NON-RCRA Waste Liquid Used Oily Water 223 <br />NON Hazardous Waste Liquid <br />Trinity Heavy Duty premixed Antifreeze <br />Trinity Extended Life premixed Antifreeze <br />Trinity Case Goods <br />Truck Wash Out <br />Truck Time <br />CE -PMS. Invoices over 30 Days are <br />subject to a 1.5% service charge, Customer agrees to pay all legal toes it court action <br />becomes necessary to Cot this Invoice. TOTAL <br />By signing I he certify that I have not mixed this waste with any other waste, that the total halides are less than 1000 PPM; and that the waste does not <br />contain any P.Cli's, I further agree to accept the additional charges for legal disposal I the waste is over 1000 PPM. total halides, or contains, any RC.B's <br />Generator's CArtifli-afion: By signing I certify that ; 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 wilt 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 iransporte(i to a facility that is reqi.)ired to comply <br />with federal regulations applicable to management of used oil, but that is not required to comply with the more stringent requiremprits 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, engineering certifications of tank integrity, and financial assurances for closure and <br />accidental releases. It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards and riot these more <br />stringent requirements. <br />This notification is for information purposes only. <br />GENERATOR/ <br />DRIVER <br />AUTHORIZED <br />"GNATURVY <br />DATE' SIGNATURE; DATE. <br />0 NAME <br />DISPOSAL I RECYCLING FACILITY <br />Aod7eESS-0 DK-0IXCN 0 RAMOS ENVIRONMENTAL SERVICE <br />7300 CHEVRON WAY 15`15 SOUTH RIVER ROAD <br />PHONE: DIXON, CA 95620 W. SACRAMENTO, CA 95691 <br />707-693-6008 916-371-5747 <br />EPA#. EPA # CAT080012602 EPA # CAD044003556 <br />MPC (4/2010) <br />