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AMERICAN VALLEY`, _ 90998 <br /> v 'E <br /> WASTE OIL, INC. RECE D Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> Pk-t-800-732-4645 • FAx 28li 68-3880JAN 0 6 2010 <br /> ENVIROWENT HEALTH <br /> BILL TO: JOB SITE: ��MIT;SERVICES <br /> J.111111 EQUIPMENT JOB M EQUIPM Invoice Date: <br /> 1245W.CHARTER 1245 W.CHARTER WAY <br /> STOCKTON.CA 95206 STOCKTON, CA 95206 <br /> 2MO OIL <br /> 9" 11 stwe <br /> PtA ,,,_ 0707 S0Tr Customer P.O. TerTA 30 Coy, EPA#CAD982464240 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE /— <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 b0 Zb 3 FLC w <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> Trinity Heavy Duty premixed Recycled Antifreeze <br /> Trinity Extended Life premixed Recycled Antifreeze <br /> Trinity Case Goods <br /> Truck Wash Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL �� <br /> becomes necessary to collect this inyi <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 PRM;and that the waste does not <br /> contain any P.C.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 P.P.M.total halides,or contains any P.C.B's <br /> Generator's Certification: By signing I certify that I 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 invoice 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 ortransfer facility. <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. _ <br /> This notification is to mation purposes only. <br /> DRIVER GENERATOR/AUTHORIZED <br /> SIGNATUREe SIGNATURE I SIGNATURE <br /> 'J' <br /> DISPOSAL / REC 1NG FACILITY O ' NAIM <br /> -Q-6K-DIXON . O RAMOS ENVIRONMENTAL SERVICE ADDRESS: ` <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD CITY/ST: <br /> DIXON,CA 95620W.SACRAMENTO,CA 95691 <br /> 707-693-6008 916-371-5747 PHONE: - � <br /> EPA If CAT080012602 EPA#CAD044003556 EPA* <br /> y <br /> MPC( ) <br />