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10c <br />BILI. TO: <br />AMERICAN VALLEY <br />WASTE OIL, INC. <br />P. O. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />CAL000827878 <br />JOB SITE: <br />Invoice Number: <br />Invoice Date: <br />Phone <br />Customer P.O. <br />Terms <br />EPA# <br />PRODUCT SHIPPING <br />DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid <br />Uscd Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid <br />USE d Antifreeze <br />133 <br />NON-RCRA Waste Liquid <br />USEd Oily Water <br />223 <br />NON Hazardous Wase <br />Liquid <br />Trinity Heavy Duty prE <br />mixed Antifreeze <br />Trinity Extended Life p <br />-emixed Nnfifreeze <br />Trinity Case Goods <br />Truck Wash Out <br />Truck Time <br />TERMS: Invoices over 30 D <br />ys are subject to a 1.510 service charge. Customer agrees to pay all legal fees if court action <br />TOTAL. <br />becomes necessary to collet <br />this invo e. <br />By signing I herby certify that <br />I haven t mixed this waste with any other waste, that the total halides are less than 1000 P.P.M: and that the waste does not <br />contain any RC.B's. I furthei <br />agree to i ccept the additional charges for legal disposal if the waste is over 1000 P.P.M. total halides. or contains any PC.B's <br />Generator's Certification: By <br />signing I dertify that I have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree I <br />have determined to be econ <br />By both parties signing this i <br />mically pr tcticable. <br />ivoice it w II serve as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the <br />generator that their waste ha <br />3 been trai isported to a licensed treatment or transfer facility. <br />American Valley Waste Oil hE <br />reby advis as the above Generator the Generators shipment of used oil may be transported to a facility that is required to comply <br />with federal regulations appli <br />able tom nagement of used oil. but that is not required to comply with the more stringent requirements applicable to hazardous <br />waste management facilities <br />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 <br />sed oil al o meet those requirements. engineering certifications of tank integrity. and financial assurances for closure and <br />accidental releases. It is law <br />ul to send used 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 inform <br />tion purpc ses only. <br />GENERATOR: <br />DRIVER <br />AUTHORIZED <br />SIGNATURE: <br />DATE: SIGNATURE: DATE: <br />O NAME <br />DISPOSAL / RECYCLING FACILITY <br />ADDRESS: <br />O DK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br />CITY.'ST: <br />7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br />DIXON. CA 95620 W. SACRAMENTO. CA 95691 <br />PHONE: <br />707-693-6008 916-371-5747 <br />r -nn . r+nrno--�nn <br />