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Phone <br />Customer P.O. <br />Payment Terms <br />S4E A*p <br />t1D-X34-t7�"Cz MIKE <br />VALLEY <br />87232 <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />_,jVRICAN <br />QUANTITY <br />PRICE <br />-- <br />WASTE OIL, INC. <br />Invoice Number: <br />P. O. Box 340 • Delhi, CA 95315 <br />USED OIL NON RCRA HAZARDOUS <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />EPA. CAL000827878 <br />221 <br />' <br />USED AUTOMOTIVE ANTIFREEZE, NON <br />Invoice Date: <br />' BILL TO: <br />JOB SITE: <br />343 <br />('j—Og4), y <br />PACIFIC TOWING <br />RAC IPTG TrOW ING <br />OILY WATER, NON RCRA HAZARDOUS <br />1444 EL PINAL DR <br />1444 EL PINAI., DR <br />S r'OCKTON, CA 95205 <br />ONE TANK 11\1 YARD & ONE <br />IN SHOP <br />S TOCKTON, CA 952(15 <br />TRINITY HEAVY DUTY PREMIX <br />2WK ANF <br />Phone <br />Customer P.O. <br />Payment Terms <br />S4E A*p <br />t1D-X34-t7�"Cz MIKE <br />Net <br />CAL0(31')2tY,15; <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 />('j—Og4), y <br />- <br />OILY WATER, NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />TRINITY HEAVY DUTY PREMIX <br />' \3 <br />RECYCLED ANTIFREEZE <br />N/A <br />I <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />G REASW EEP <br />N/A <br />rip fify _ � aes, .-are Fremix recycled i rPez <br />. <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 waste isP.P.over TOTAL <br />1000 M. total halides, or c . tefrles any P.C.B.'s. <br />-' <br />DRIVER GENERATOR/AUTHORIZED.. <br />SIGNATURE :. _„_ _ SIGNATURE SIGNAURE.---=-- <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 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 requirements. <br />This notification is for information purposes only. <br />Driver signed Date Generator signed 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 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 DK-DIXON O RAMOS ENVIRONMENTAL SERVICES <br />7300 CHEVRON WAY • DIXON, CA 95620 1515 SOUTH RIVER ROAD • W. SACRAMENTO, CA 95691 <br />800-727-2879 • EPA If CAT080012602 916-371-5747 • EPA # CAD044003556 <br />MPC (01=0 <br />