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( mERICAN VALLEY <br />STE OIL, INC. <br />P. O. Box 340 • Delhi, CA 95315 <br />PH. 1-800.-732-4645 • FAX 209-668-3880 <br />EPA. CAL000827878 <br />Invoice Number: <br />Invoice Date: <br />BILL TO: MARINA 3. 0AT ISA,..0133 JOB SITE: MARINA EtOV S)Ak-PS <br />RO BOX 729 820 , I:1EC--KIViANJ RD, <br />t.00.);, CA 9,5(., <br />Sai as Rep: <br />'-e3 C ff ,, IK <br />Customer P.O. <br />PayTpI krgs <br />EPA,Ik <br />S <br />PRODUCT SHIPPING.DESCRIPTION <br />WASTE <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />USED OIL NON RCRA HAZARDOUS <br />_� <br />WASTE LIQUID <br />221 <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 />N/A <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />.I iii ky F)dende:Nd I..ile Premix recycled Antil'fti� v <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 />a ,m.-•�4f <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 />TOTAL <br />y <br />1000 P.P.M. total halides .o taine any P.C.B.'s. <br />DRIVER f, GENERATOR/ AUTHORIZED <br />SIGNATURE SIGNATURE SIGNATURE <br />TERMS: INVOICES 3C) DAYS ARE SUBJECT TO A 1.5% 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 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 requirerpemts, <br />This notification is fgr'int 7malionurposes only. �.- , "'.7. ` <br />Driver signed a/ ;+- . - Date*` _ "'f �% s' Generator signed Date <br />By signing thejl:h%"ce,the ggenerator certifies that the generator has established a program to reduce the 4ol6rrie or 4,uantity and toxicity of the hazardous <br />waste to the degree, as d4termined 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 RIVERBANK OIL TRANSFER 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 />i <br />MPC (10/2004) <br />