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Mar 12 OS 08: 26a tom price 209-365-13781 p. 7 <br /> AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice Nuinum <br /> P. O. Box 340 - Delhi, CA 95315 <br /> - PH-1-800-732-4645 * FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> Phone h Customer P.O. Payment Terms EPA# <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 NIA <br /> GREASWEEP NIA <br /> I hereby certify that I have not mixed this waste with any other waste,that the total halides are less 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 0 this waste is over TOTALI <br /> 1000 P.P.M.total halides,-cr oontaines any_MC,B.'s. <br /> DRIVER GENERATOR/AUTHORIZED, <br /> SIGNATURE <br /> SIGNATURE/ SIGNATURE <br /> TERMS: INVOICES-00VER 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 rjosure 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 requinemOM. <br /> This notification is for information pwqj)oses only. <br /> &nerator signedr- <br /> Driver signed Date Date <br /> By signing the invoice the generator certifies that the generator has established a program to red�ce2the;lol6iWe'—o' -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 their waste has been transported to a license treatment or transfer facility. <br /> DISPOSAL/ RECYCLING FACILITY <br /> C) I RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br />