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' • - � MERICAN VALLEY Invoice Number: WASTE OIL, INC. P. 0. Box 340 • Delhi, CA 95315 � 70046 PH. 1-800-732-4645 • FAX 209-668-3880 EPA. CAL000827878 Invoice Date: GILL TO: JOB SITE: Phone Customer P.O. :Paym:entTerms EPA# PRODUCT SHIPPING DESCRIPTION , WASTE MANIFEST QUANTITY PRICE AMOUNT CODE USED OIL NON RCRA HAZARDOUS 221 (J"� WASTE LIQUID USED AUTOMOTIVE ANTIFREEZE, NON RCRA HAZARDOUS WASTE LIQUID 343 OILY WATER, NON RCRA HAZARDOUS WASTE LIQUID 221 TRINITY HEAVY DUTY PREMIX RECYCLED ANTIFREEZE N/A NON HAZARDOUS WASTE LIQUID TRUCK TIME !� N/A GREASWEEP '� N/A 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 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 TOTAL- 1000 P.P.M.total halides,or containes any P.C.B.'s. 'DRIVER �/� f GENERATOR AUTHORIZED SIGNATURE ii C. SIGNATURE /SIGNATURE TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES TO PAY ALL LEGAL FEES IF COURT/ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. Americ�rM'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 with federal regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facilities. California facilities that handle or process used oil are required to meet those more stringent requirements, and some out-of- state facilities that process used oil also meet those requirements, engineering certifications of tank integrity, and financial assurances for closure and 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 stringent requirements. This notification is for information purposes only. r Date Driver signed_ / �'�'� _ Date ^' � )�� Generator signed By signing ihe'invoice the generator certifies that the generator has established a program to reduce the volume or quantity and toxicity of the hazardous wasteto 9degree,as determined by the generator,to be economically practicable. 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 that their waste has been transported to a license treatment or transfer facility. DISPOSAL / RECYCLING FACILITY O RIVERBANK OIL TRANSFER O RAMOS ENVIRONMENTAL SERVICES 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO, CA 95691 209.863-8181 • EPA#CAL000190816 916-371-5747• EPA#CAD044003556 MPC(10/2004)