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AMERICAN VALLEY 21907 <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 /> EPA. CAL000827878 Z-7 ' �1 J <br /> Invoice Date: (J I <br /> i� <br /> r T0: JOB SITE: <br /> VAN DE FOL STOCKTON TRI INDUSTRIES <br /> z . 0 BOX 1107 2141 E . ANDERSON <br /> STOCKTON, CA 95201-1107 STOCKTON, CA 95201 <br /> Phone Customer P.O. Payment Terms EPA# <br /> VAN DE POL Net 30 Dai � :1 CAL000071242 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS / <br /> WASTE LIQUID 221 <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 134 i <br /> OILY WATER, NON RCRA HAZARDOUS 2—/lel' 2J�6 S C� <br /> WASTE LIQUID 221 <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> HALOGEN TEST N/A <br /> SLUDGE, NON-RCRA HAZARDOUS <br /> WASTE LIQUID N/A <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE. CUSTOMER AGREES <br /> TO PAY ALL LEGAL FEES IF COURT ACTT ECOMES NECESSARY TO COLLECT TJ II INVOICE. TOTAL <br /> DRIVER CUSTOMER <br /> SIGNATURE SIGNATURE <br /> THANK YOU <br /> DISPOSAL / RECYCLING FACILITY <br /> O INDUSTRIAL SERVICE OIL CO INC. O CHICO DRAIN OIL SERVICE C7 RIVERBANK OIL TRANSFER <br /> 1700 S. SOTO ST. 1618 W. 5TH ST. 5300 CLAUS ROAD <br /> LOS ANGELES, CA 90023 CHICO, CA 95928 RIVERBANK, CA 95367 <br /> CAD099452708 CAD980694103 CAL000190816 <br /> 562-598-5577 530-345-9043 <br /> MPC »/' <br />