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AMERICAN VALLET <br /> WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> CAL000827878 <br /> BILL TO: JOB SITE: Invoice Date: <br /> LE AUTtCMO,'' ASTLE AU TOMOTIVE <br /> 2315 N.EL DORADC 2315 ht.EL DORADO <br /> STaCK70I4.CA 95' A-ALPtN <br /> Phone Customer P.O. Terms EPA# <br /> PRODUCT SHIPPING DESCRI TION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used it/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used ntifreeze 133 <br /> NON-RCRA Waste Liquid Used ily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Anti reeze <br /> Trinity Extended Life premixed An ifreeze <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subjeci to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have not m xed this waste with any other waste,that the total halides are less than 1000 PRM;and that the waste does not <br /> contain any P.C.B's. I further agree to acc pt the additional charges for legal disposal if the waste is over 1000 P.P.M.total halides,or contains any RC.B's <br /> Generator's Certification: By signing I cert y 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 economically practi able. <br /> By both parties signing this invoice it will s rve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the <br /> generator that their waste has been transp rted to a licensed treatment or transfer facility. <br /> American Valley Waste Oil hereby advises a 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 mana ement of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waste management facilities.California fa lities 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 eet those requirements, engineering certifications of tank integrity, and financial assurances for closure and <br /> accidental releases. It is lawful to send us d 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 information purposes only. <br /> GENERATOR/ <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE: SIGNATURE: DATE: <br /> O NAME: DISPOSAL / RECYCLING FACILITY <br /> ADDRESS: O DK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br /> CITY/ST: 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> DIXON, CA 95620 W.SACRAMENTO. CA 95691 <br /> PHONE: 707-693-6008 916-371-5747 <br /> EPA#: EPA#CAT080012602 EPA#CAD044003556 <br /> MPC(4,2010) <br />