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AMERICAN VALLEY` c <br />WASTE, OIL, INC. Invoice Number: <br />P. 0. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />EPA. CAL000827878 tt <br />Invoice Date: <br />BILL TO: <br />�g h f, �y JOB SITE: T a c f A 1 <br />NA <br />P D. 130X 09 Vii;. 013 94=`0Ig,N9>< Pa RP, <br />I_.l )DI, C.; A 9,,'-)241 C '. '95e".42 — <br />Phone <br />Customer P.O. <br />Payment Terms <br />EPI p <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />USED OIL NON RCRA HAZARDOUS <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 />f 0ty i-xfend(-)d t.11f Pf-ernix recyded Aflfiff ?�:!xa: <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 contaip a y 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 halid -I or Qontaines any P.C.B.'s. TOTAL <br />Y - <br />DRIVER j GENERATOR/ AUTHORIZED / <br />SIGNATURE '' '' �' �'�• _--�—'""- SIGNATURE SIGNATURE <br />TERMS: INVOICE, OVER 30 D,4S 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 requirement§. <br />!. <br />This notification is for�j jorfxl�on Vrposes only. .• � , <br />Generator sig nedDriver signe,f.Date"'.- <br />By signing the (rwo(ce the generator certifies that the generator has established a program to reduce the volume or qua tinua tin y 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 />(0 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 />MPC 00/20( <br />