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Jul, 16. 2010 6: 54AM Golan State Irrigation No, 0351 P. 6 <br /> AMERICAN VALLEY 9 4 f <br /> WASTE OIL, INC, Invoice Number: <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PH. 1.800.732.4645 • FAX 209.668-3880 <br /> EPA. CALOW627878 <br /> BILL TO: JOB SITE: Invoice Date: <br /> GOLDEN STATE IRRIGATION GOLDEN 51ATE IRRK3A110N <br /> 1648 SHAW RD 1648 SHAW RD. <br /> STOCKTON,CA 95213 STCY:KrON,CA 95213 <br /> Phone Customer P.O. Terms EPAk gales mepitAeve <br /> 209-943-7774 1 C.O.D. CAL00018U794 <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 /> Trinity Heavy Duty premixed Recycled Antifreeze <br /> Trinity Extended Life premixed Recycled Antifreeze <br /> Trinity Case Goods <br /> Truck Wash Out. <br /> Truck Tliile t i' <br /> A. <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 necessary to collect this Invoice. <br /> By signing I he 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.C.9'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.B's <br /> Generatoes 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 1 <br /> have determined to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil Will submit confirmation for(certain waste streams)to the <br /> generator that their waste has been transported to at licensed treatment or transfer facility. <br /> American Valley Waste Oil hereby advises the above Generator the Generators shipment of used all 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 stringant 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-slate 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 � /' GENERATOR AUTHORIZED` <br /> SIGNATURE ; SIGNATURE /SIGNATURE /,. <br /> DISPOSnAL/ RECYCLING FACILITY O NAME: <br /> n.DK-DIXON ADDRESS: <br /> J*+ O RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD CITY/ST: <br /> DIXON,CA 95620 W_SACRAMENTO, CA 95691 <br /> PHONE; <br /> 707-693-6008 <br /> 916,371-5747 <br /> EPA q CAT060012602 EPA 8 CAD044003556 EPA#: <br /> MPC 09/2009) <br />