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AMERICAN VALLEY <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:CASTLE AUTOMOTiVE JOB SITE: A4;LE AU T OM <br /> A., <br /> f ,a EL C Invoice Date: <br /> Int <br /> 2345 N.EL DORADO - � �:� ORA�-D <br /> STOICKTON.CA 95204 ': Ai <br /> Phone Cu tomer P.O. Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTIO WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/ fixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antif eeze 133 <br /> NON-RCRA Waste Liquid Used Oily ater 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Antifree e <br /> Trinity Extended Life premixed Antifreeze <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subject to a .5%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> oecomes necessary to collect this invoice. <br /> 3y signing I herby certify that I have not mixed t is waste with any other waste,that the total halides are less than 1000 P.P.M;and that the waste does not <br /> :ontain any P.C.B's. I further agree to accept th additional charges for legal disposal if the waste is over 1000 RRM.total halides,or contains any P.C.B's <br /> 3enerator's Certification: By signing I certify tha I have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree I <br /> lave determined to be economically practicable. <br /> 3y both parties signing this invoice it will serve s an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the <br /> Generator that their waste has been transported o a licensed treatment or transfer facility. <br /> American Valley Waste Oil hereby advises the ab ve Generator the Generators shipment of used oil may be transported to a facility that is required to comply <br /> with federal regulations applicable to manageme t of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> Naste management facilities.California facilities hat 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 hose requirements, engineering certifications of tank integrity, and financial assurances for closure and <br /> accidental releases. It is lawful to send used oil o 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 />