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AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice NL1l11b01': <br /> P. C. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-1645 • FAX 209-668-3880 <br /> EPA. CAI 000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> 4:":1 ,�i lif.P'all4-;i'i.l`� Ii, iR:+„1 },i r'� i;�ti�d'it•'�1.`' 'i`l,'l,li:�';.:t.f`Sl.r <br /> - .-inat'.It..•I'� ill�t"•Y t.�.!�� ';�� �', .. `i t�.f'-!._ �I°' ..r{-: <br /> Ir_- <br /> r .. <br /> r Phone Customer P,O. Payment Terms EPA# <br /> Is PRODUCT SHIPPING DESCRIPTION WASTE' MANIFEST QUANTITY PENCE 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 /> F:=:f OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE NIA <br /> r SN HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> r.-.. <br /> k1 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.accepi the additional charges forlegal.disposal if this waste is over TOTAL <br /> 1000 P,P.M_total halides,or conlaines any P:C_8.'s. <br /> DRIVER. GENERATOR :A.UTHORIZED ,'r ! P s ,:• <br /> SIGNATURE 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 /> -,1 American.Valley Waste Oil hereby advlsos 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,.Itis lawful to send used oil to out-of-state tacil!tles that comply only.with federal used ()til management standards and not these more <br /> stringent requirements. a <br /> y I <br /> This notification Is for information purposes only. fA. <br /> Driver signed a = Date ' Generator si.gnedk__1"_�f. f Ir- J —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 econoinically practicable. <br /> y 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 /> "-':fat their waste has been transported to a license treatment or transfer facility. <br /> _j DISPOSAL 1 RECYCLING FACILITY <br /> O RIVERBANK OIL TRANSFER Q RAMOS ENVIRONMENTAL SERVICES <br /> 5300.CLAUS ROAD■ RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W. SACRAMENTO,CA 95691 <br /> 209-863.6181 • EPA#.CAL000190816 916-371-5747•EPA#CAD044003556 <br /> -- MPG:(10120 <br />