Laserfiche WebLink
AMERICAN VALLF•" ' <br /> WASTE OIL, INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 7 5 91 5 <br /> PH. 1-800-732-4645 • FAX 209.668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> PP4'M L"W. rJ7 17 F <br /> i=ARMING; r0N RED <br /> 3131 rA'r'lNfll'�Cy i r:3ri i?u <br /> STO,KTON CA X15205 <br /> X: HVVP yy <br /> 7aIfS rtep <br /> Phon�9-942-31 31 <br /> Customer P.O. Payment Terms EPA# <br /> n n ;A,L(??1r,2 114o <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 N/A <br /> 7rtr ty Ewpj.idc-rd L,Lfn Premix rerycilpd.A.nb ti <br /> Fue( Sur ';hatge �kl (Y] <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 vlaste is over <br /> 1000 P.P.M.total halides,or container any P.C.B's. 'I TOTAL <br /> DRIVER q 1'7 GENERATOR AUTHORIZED/ t1 l <br /> SIGNATURE I' i/ SIGNATURE/SIGNATURE <br /> TERMS: INVOICES OVER 30 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 6e r nsported'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 requirements. <br /> This notification is for informatl n p Lp as only. i - <br /> `p/ / ) C yi I' <br /> Driver signed %� / ' Date Generatorsigne¢, .II �� —" Date .i�� <br /> By signing the invoice the ge era r certifies that the generator has established a program reduce the volume] r 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 to((certain waste streams) to the generator <br /> that their waste has been transported to a license treatment or transfer facility. <br /> i <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 /> MPC(tC <br />