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PACIFIC TOWING <br />1444 EL PiNAL DR <br />STOCKTON, CA 95205 <br />WMERICAN VALLEY 86389 <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. CAL000827878 <br />JOB SITE: PACIFIC TOWING Invoice Date: <br />1444 EL PINAL DR <br />ONE TANK IN YARD & ONE IN SHOP <br />STOCKTON, CA 95205 <br />2VVK ANF <br />Sales Rep: <br />PMFIe464-QG113MIKE <br />CustornerP.O. <br />Paynp"T71 ys <br />EPA At-QQQ2Q?157 <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST QUANTITY PRICE 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 />7 t U <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />Trinity Ddendpd Life Prcmfx recycled An ifreez.- <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 <br />not contain any P.C.B.s. I further agree to accept the additional charges for legal disposal if this waste is over <br />P.P. <br />1000 M. total halides, or eont_aines any P.C.B's. TOTAL <br />S Y <br />DRIVER l' GENERATOR/AUTHORIZED <br />`�------ <br />SIGNATUREC• SIGNATURE SIGNATURE .I <br />TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER AGREES TO PAY ALL LEGAL FEES IF <br />COURTACTION BECOMES NECESSARYTO COLLECTTHIS 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 with the <br />comply 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 toxicityof 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 # CAT080012602 916-371-5747 • EPA 4 CAD044003556 <br />MPC (01/2009) <br />lov <br />