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Jan. 5. 2013 12:08PM N,, 4018 P. 4 <br /> 0 kMERICAN VALLEY 112020 <br /> WASTE OIL, INC. Invoice Nuinber: <br /> P. 0.Box 340 - Delhi, CA 95315 <br /> PH. 1-800-732.4645 1 FAX 209-668-3880 <br /> CAL000827878 <br /> 1211t;I- le <br /> BILL TO: JOB SITE: An voice bate: <br /> BROOM DE COUNTRY CLUB BF OOKSIDE COUNTRY CLUB <br /> 3603 ST.ANDREW$OR 3130 BROOKSIDE R0. <br /> 9TOCKTON,CA 05219 STOCKTON, CA 96219 <br /> X MARCH LANE <br /> Phone Customer P.O. Terms EPA# <br /> 209-476-9963 ROBIN - - I Net 30 Days 1CAL000205437 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> NON Hazardous Waste Liquid <br /> 1hpt.. <br /> —'p <br /> N <br /> Trinity Heavy Duty premixed Antifreeze Date: <br /> Trinity Extended Life premixed Antifreeze rat: <br /> A-LIL <br /> U <br /> pity Case Goods <br /> Truck Wash Out ted <br /> Truck Time U apy; <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 neoessary,io collect this invoice. <br /> Bysigning 1her 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 <br /> contain any P.M.'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.Ws <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(his Invoice it will serve as an agreement that American Valley Waste Oil will submit oonfirmation for(certain waste streams)to the <br /> generator that their waste has been transported to a licensed treatment or transfer facility. <br /> American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may be transported to a facility[he(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 lank 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 /> sifingent requirements. <br /> 'This notification is for information purposes only. <br /> GENERATOW <br /> DRINATU TE: AU CSN <br /> DATE:// y//,� <br /> __ZJ4 <br /> 0 NAME <br /> DISPOSAL/ RECYCLING FACILITY <br /> ADDRESS: VDK-DIXON <br /> 0 RAMOS ENVIRONMENTAL SERVICE <br /> CITYIST: 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD <br /> DIXON,CA 95620 W.SACRAMENTO, CA 95691 <br /> PHONE: 707-693-6008 916-3711-6747 <br /> EPA#: EPA#CAT080012602 EPA#CAD044003556 <br /> MPO(4/2010) <br />