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Mar 12 09 08: 31a tom price 209-365-6781 p. 1 <br /> " AMERICAN VALLEY <br /> ' WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> 77961. <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> /i EPA. CAL000827878 <br /> (. SOS <br /> j Invoice Date: <br /> BILL TO: GASOLINEALLEY JOB SITE: GASOLINEAL.LEY <br /> 820 S. BECKMAN RD 820 S. BECKMAN RD <br /> LODI, CA 95240 LODI CA 95240 <br /> mal ' Sales Neo: EDWARDGARCw <br /> Phone Customer P.O. ,_ _ Pay�tTerms EPA# <br /> 209-365-6747 TOM Net:30 Days CAL.000267320 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> USED OIL NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> USED AUTOMOTIVE ANTIFREEZE, NON <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASW EEP N/A <br /> Trinity Extended Life Premix. recycled Antifreez <br /> I hereby certify that I have not mixed this waste with any other waste,that the total halides are iess than 1000 P.P.M.;and that <br /> the waste does not contain any P.C.B:s.I further agree to accept the additional charges for legal disposal if this waste is over <br /> 1000 P.P.M.total halides,or container rl0y P.C.S.'s. TOTAL c.aS <br /> DRIVERf GENERATOR AUTHORIZED _ <br /> SIGNATURE `Jk SIGNATURE/SIGNATURE <br /> TERMS:INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE.CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br /> COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br /> American Valley Waste Oil hereby advises the 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 management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous <br /> waste management facilities.California facilities 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 meet those requirements, engineering certifications of tank integrity, and financial assurances for closure and <br /> accidental releases. It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards and not these more <br /> stringent requirements. ;This notification is for in "atio purposes only. <br /> Driver signed �bate - ?' L Generator signedDate / <br /> By signing the invoice the generator certifies that the generator has established a program to reduce the volume or quantity and toxicity of the hazardous <br /> waste to the degree,as determined by the generator,to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that American Valley will submit confirmations for(certain waste streams)to the generator <br /> that Meir waste has been transported to a license treatment or transfer facility. <br /> DISPOSAL/ RECYCLING FACILITY <br /> RIVERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD•RIVERBANK,CA 95367 1515 SOUTH RIVER ROAD•W.SACRAMENTO,CA 95691 <br />