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SILL TO: <br />AMERICAN VALLEY* 8 9 0 4 !�e <br />WASTE OIL, INC. . Invoice Number: <br />R O. Box 340 • Delhi, CA 95315 <br />PH..1-800732-4645 - FAX 209-668-3880 <br />EPA. CAL000827878 <br />�� A I f. <br />�u t <br />Invoice Date: <br />JOB SITE: <br />1-01911 q, 5 <br />Phone <br />Customer P.O. <br />Payment Terms <br />EPA# <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />USED© RCRA HAZARDOUS <br />23 +7p <br />) <br />WAST LIQUID <br />221 <br />a4a.9 -e <br />USED AUTOMOTIVE ANTIFREEZE, NON <br />RCRA HAZARDOUS WASTE LIQUID <br />343 <br />OILY WATER, NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />TRINITY HEAVY DUTY PREMIX <br />RECYCLED ANTIFREEZE <br />NAA <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />NIA <br />GREASWEEP <br />N/A <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 if this waste is over <br />4 <br />1000 RP. M, total halide!j,.or container an P.C.B's. TOTAL <br />DRIVER /� / c GENERATOR' AUTHORIZED <br />SIGNATURE � f - _.rte SIGNATURE SIGNATURE A `� ✓� <br />TERMS: INVOICE,OVER 30 PAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br />COURT ACTIONBECOMESNECESSARY 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 ail, 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 requiremen's. <br />This notification is for inf r faxfmn purposes only. <br />Driver signed '� 'f Date ^` Generator signed w .^i•� 6<,�?F L• f'�::..57Date <br />By signing the invoi e lK5 'genu�` or certifies that the generator has established a program to reduce the volurn`e or quantity and toxicity of the hazardous <br />waste to the degree, as deter7led 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 />.--Q'&-DIXON 'O RAMOS ENVIRONMENTAL SERVICES <br />7300 CHEVRON WAY - DIXON, CA 95620 1515 SOUTH RIVER ROAD • W. SACRAMENTO, CA 95691 <br />800-727-2879 •'EPA # CAT080012602 916-371-5747 • EPA # CAD044003556 <br />MPC (0v200! <br />