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AMERICAN VAS, y <br />WASTE OIL, IN6 Invoice Number: <br />P O. Box 340 - Delhi. CA 95315 APR 1. 3 2015 <br />PH. 1-800-732-4645 - FAX 209-668-3880 <br />CAL000827878 1--NVIRONMENT:A.L . <br />LOVE'S TRAVEL STOPS <br />RILL TO: ATTENTION: MICHAEL KEY <br />10601 NORTH PENNSYLVANIA JOB SITE: RIPPION CA 95M Invoice Date: <br />OK AHOMA CITY, OK 73126 <br />Sales Rep: <br />Ph ;Customer P.O.7 Te EPA# <br />� I � <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST <br />OUANTITY <br />PRICE AMOUNT <br />CODE <br />i <br />NUN-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />if <br />23 <br />NON Hazardous Waste Liquid <br />--r <br />Trinity Heavy Duty premixed Antifreeze <br />i <br />- <br />- <br />Trinity Extended Life premixed Antifreeze <br />Trinity Case Goods <br />-- <br />Truck Wash Out <br />- <br />Trude Time <br />. - <br />TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal tees it court action <br />becomes nvoices r t r 3 Da <br />y collect this invoice I <br />TOTAL <br />By signing I herby certify that I have not mixed this waste with any other waste, that the total halides are less than 1000 PP.M; and that the waste does not <br />contain any PC.B's. I further agree to accept me additional charges for legal disposal if the waste is over 1000 PPM. total halides. or <br />contains any PC.B's <br />Generator's finedCertificationbe: By signing I certify that 1 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 practicable. <br />By both parties signing this invoke it will serve as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the <br />generator that their waste has been transported to a licensed treatment <br />or transfer facility. <br />American Valley Waste Oil hereby advises the above Generatur the Generators shipment of used oil may be transported to a facility that is required to comply <br />with federal regulations applicable to management of used oil, but that is not required to comply with the more stringent requirements <br />waste <br />applicable to hazardous <br />management facilities. California facilities that handle or process used oil are required to meet those more stringent requirements, and some gut i7f• <br />slate facilities that process used oil also meet those requirements, engineering certifications of tank integrity, and financial <br />assurances for closure and <br />accidental releases It is lawful. to send used oil tg out-of-state facilities that comply only with federal used oil management standards and not these more <br />stnngent requirements <br />This notification is for inform ion purposes only _ <br />DRIVER __ GENEP,AP <br />SIGNATURE AUTHOR12ED <br />.. DATE: j "� %�j SIGNATUR <br />•�t�� DATE' <br />0 NAME <br />� "--------- DISP <br />AQ4A£3S: RECYCLING .�ACI-LITY <br />"-OK-DIXON O RAMOS ENVIRONMENTAL SERVICE <br />Ctrrrsr 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br />DIXON. CA 95620 <br />PHONE.- 707-693-6008 W. SACRAMENTO, CA 95691 <br />916-371.5747 <br />EPA # CAT080012602 EPA * CAD044003556 <br />VRC,a12010) <br />