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AME CAN VALLEY49 90296 <br /> WASTE OIL, INC. Invoice Number: <br /> R O.Box 340 - Delhi, CA 95315 <br /> PH. 1-800-732-4645 -a FAX 209-668-3880 <br /> EPA.CAL000827878 <br /> Invoice Date: <br /> ';IF i�OUNI Y <br /> BILL TO: JOB SITE: F! 0 K <br /> At.A.)F""P0iS, L <br /> C.A. 951-19 <br /> X., kfAF.C;l4 <br /> Customer P.O. Paym <br /> ,Nqnet '��t Terms EPA.#, <br /> l O�Vs <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 <br /> RECYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP NIA <br /> 1'nnft �k'rended Lkfe Fllro_x recycicud Antfileq:;A--' <br /> I hereby certify that I have not mixed this waste with any other waste,that the toted halides are less than 1000 R 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 /> 1000 P.P.M.total halides,or contains any P.C.B.'s. TOTAL , <br /> DRIVER GENERATOR/AUTHORIZED <br /> SIGNATURE SIGNATURE / SIGNATURE <br /> TERMS:INVOICES OVER 30 DAYS ARE SUBJECTTO A 1.50%SERVICE CHARGE.CUSTOMER AGREES 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 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 these 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 /> Driver signed Date Generator signed Date <br /> By signing the invoice the generator certifies that the generator has established a program to reduce the 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 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 /> O.DK-DIXON 0 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(01/20 <br /> L-d C966-9Zt-60Z 8JIGAI!S nol ett:01, 60 ZI, AON <br />