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AMERICAN VALLEY 48754 <br /> WASTE OIL, INC. <br /> Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732.-4645 • FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> i <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> JIM THORPE OIL INC.. CITY OE' STOCKTON <br /> C.O. BOX 357 X1.6 N. CALIFORNIA <br /> LOUI, CA 95241 STOCKTON, CA 95205 <br /> 5: MINER <br /> Phone Customer P.O. Payment Terms EPA# <br /> P. <br /> 1 C ;30 Davs CAC002584589 <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 V <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP _ 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 TOTAL <br /> 1000 P.P.M.total halides,or containes any P.C.B:s. <br /> DRIVER GENERATOR AUTHORIZED <br /> SIGNATURE SIGNATURE SIGNATURES ' <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE.CUSTOWh A REES 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 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 t more stringent requirements,hpplicable 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 for information purposes only. ! . <br /> / r <br /> Driver signed Dates �` Generator signed 13 1 - ��,7Datei y <br /> By signing the invoice the generator certifies that the generator has a program to reducee 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 suit 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 /> O RIVERBANK OILTRANSFER O RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO,CA 95691 <br /> 209-863-8181 •EPA#CAL000190816 916-371-5747•EPA#CAD044003556 - <br /> MPC <br />