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JaN-L�-LUIUI�'lUN) 11 , LL (hAX)�IU� SbU���� P, UUL 'UUL <br /> AMERICAN V ALLEY �-�- t_�•t,,� <br /> WASTE OIL, INC. Invoice Number: <br /> P 0. Box 340 @ Delhl, CA 95315 <br /> PH. 1-800-732-4645 - FAX 209-668-3880 <br /> BILL TO: JOB SITE: Invoice Date: <br /> HAIR fJ All lU FtE�F'AI!! <br /> a1(1;t Pl.IVl�llfdl 403 L.MAIN :51 <br /> STCCKFON, CA 115206 <br /> `J <br /> Phone Customer RO: Terms EPA## <br /> 209-463-6811,,1 »IEH G.U.ID. C.AL(.II_)U2t3'Ifj(.;1 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oifs 221 <br /> NON-RCRA Waste LigdIld Used Antifreeze 133 (�, .�•nom ync, -I.J, <br /> NON-RCRA Waste Ligl ld Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty pro IIxed Recycled Antifreeze r• , `�' f- I t ' <br /> i1 -t� •. �� 11{" <br /> Trinity Extended Life premixed Recycled Antifreeze <br /> I <br /> Trinity Case Goods — <br /> Truck Wash Out <br /> i <br /> Truck Tlme <br /> I <br /> I <br /> TERMS: Invoices over 30 Day'p Are subject to a 1.5',6 eervlce charge. Customer Rgreoc to pay all legal foes If court action TOTAL <br /> boc❑rncs rocossary to colicct this Involce. ' <br /> Dy slgning I horby codify[hat (havo not mlxod this waste with any otnor waste. that the total halides aro less than 1000 RP.M;and that the waste does nal <br /> contain any f.0-6'a. I furmar agree to accept the addttlonal charges for legal dlsposal If the waste Is over 1000 PPM-total halldos,or contains any PC.B's <br /> Gonerator's Certification: By slpning I certily[hat I have a program in place to reduce the volume and toxicity at hazardous waste generated to [he degree I <br /> have determined to be economically practicable. <br /> By both parties algnlng this Invoice II will serve as an agreement that American Valley Waste Gil will submit conlirmalion for(certain waste streams)to tho <br /> generator that their waste has deem transported to d licensed treatment or transfer facility. <br /> American Valley Waste OII hereby advises the above Generator the Generators shipment of used oll may be transported to a facility[hat is required to comply <br /> with lederal regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waslo management facilities.Callfornla faclllllos that handlo or process usod all aro "Itilrod to moot those more Ortnyant roqulramants,and sorno oul•ol- <br /> slale facilities that process Dad oil also moot those requlremen[s, englnooring cortlf cations of tank Inlagrlly, and financial assurancos for closuro and <br /> accidental releasee- It is lawful to send used oil to out-of-state facilities that comply only wllh federal used oil management slandards and not these more <br /> Stringent roqulremonts. <br /> This notification is for informal aft•purposos only. <br /> DRIVER ,�. GENERATOR/AUTHORIZED <br /> SIGNATURE ` . : SIGNATURE SIGNATURE <br /> DISPOSAL /-IRECYC-LING FACILITY O NAME: <br /> O DK DIxON ADDRESS: <br /> i O RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY CITY/5T <br /> 1515 SOUTH RIVER ROAD <br /> DIXON, CA d 5620 W.SACRAMENTO, CA 95691 PHONE: <br /> 707-693-60081 910.371.5747 <br /> EPA 0 CAT080012.602 EPA #CAD044003556 EPA4 <br /> MF'0 1101'X09) <br />