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BILL TO: <br />-� AMERICAN VALLEY 86107 <br />WASTE OIL, INC. Invoice Number: <br />I P. 0. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />EPA. CAL000827878 <br />�V <br />1 <br />y <br />a <br />> J J <br />r"•�f ' <br />�•- - Invoice Date: <br />JOB SITE: ;. w } <r , g': <br />f _.. <br />i <br />Phone <br />Customer P.O. <br />Payment Terms <br />EPA# <br />_3 <br />PRODUCT SHIPPING DE <br />CRIPTION <br />WASTE <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />USED OIL NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />USED AUTOMOTIVE ANTIFREEZE, <br />NON <br />RCRA HAZARDOUS WASTE LIQUID <br />343 <br />OILY WATER, NON RCRA HAZARDOUS <br />221 <br />6 <br />-- <br />WASTE LIQUID <br />TRINITY HEAVY DUTY PREMIX <br />RECYCLED ANTIFREEZE <br />N/A <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />I hereby certify that I have not mixed this <br />waste 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 <br />I further agree to accept the additional charges for legal disposal if this waste is over TOTAL <br />99 <br />Y _ <br />1000 P.P.M. total halides, or containes any <br />P.C.B.'s. <br />DRIVER <br />GENERATOR AUTHORIZED <br />SIGNATURE <br />SIGNATURE/ <br />30 DAYS <br />ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES T-0 PAY ALL LEGAL FEES IF <br />TERMS: INVOICES OVER <br />COURT ACTION BECOMES NECESSARY <br />TO COLLECT THIS INVOICE. Y" <br />American Valley Waste Oil hereby advises <br />tom <br />the above Generator the Generators shipment of used oil may be transported to a facility that is required to comply <br />anagement of used oil, but that is not required to comply with the more stringent requirements applicable to hazardous <br />with federal regulations applicable <br />waste management facilities. Californi <br />facilities that handle or process used oil are required to meet those more stringent requirements, and some out-of- <br />engineering certifications of tank integrity, and financial assurances for closure and <br />state facilities that process used oil a <br />accidental releases. It is lawful to send <br />so meet those requirements, <br />used oil to out-of-state facilities that comply only with federat'used oil management standards and not these more <br />stringent requirements. <br />This notification is for information purp <br />ses only. <br /><' '�."�• =`,�Y ,...�--- r-�:.a.... <br />Driver signed <br />By signing the invoice the generator certifies <br />Date r Generator signed -`"" Date <br />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 b <br />By both parties signing this invoice it will <br />the generator, to be economically practicable. <br />serve as an agreement that American Valley will submit confirmations for (certain waste streams) to the generator <br />that their waste has been transported <br />o a license treatment or transfer facility. <br />DISPOSA <br />/RECYCLING FACILITY <br />O RIVERBANK OILTRA14SFER <br />O RAMOS ENVIRONMENTAL SERVICES <br />5300 CLAUS ROAD <br />RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD - W. SACRAMENTO, CA 95691 <br />209-863-8181 - EPA it <br />CAL000190816 916-371-5747 - EPA # CAD044003556 <br />MPC (10 <br />