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&ERICAN VALLEY <br />WASTE OIL, INC. <br />•'e t-3 94 <br />c <br />Invoice Number: <br />j P. O. Box 34Delhi, <br />PH. 1-800-732-466 245 •FAX 209-668--668- <br />3880 <br />EPA. CAL000827878 <br />/ Invoice Date: <br />FIC TG+WEtlC JOB SITE: P.A1,- C, IC)41V1NG <br />1444 k L FINAL DR. <br />,14=14 ; L FINAL I;F2 ONE TANK IN YARD & ONE IN SHOP <br />S-"0(1KTC.fl. CA 95205 S'TOC;KT"QIP!, CA 9ri2CY5 <br />?WKANF <br />Saar. rias,, <br />209-863-8181 • EPA # CAL000190816 MPC 110120 <br />Customer P.O. Paywmt-�?10184yS <br />EPA�#14.09.i ?;7315 <br />PhoncaRA,ov1(, MlICG. <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 r� C <br />RCRA HAZARDOUS WASTE LIQUID 343 <br />OILY WATER, NON RCRA HAZARDOUS 221 <br />WASTE LIQUID <br />TRINITY HEAVY DUTY PREMIX <br />N/A <br />RECYCLED ANTIFREEZE - <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME N/A <br />GREASWEEP N/A <br />rriorhi Exlewled I_ife Premix recyclai Antifreez <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 />P.C.B.'s. I further agree to accept the additional charges for legal disposal if this waste is over TOTAL. <br />the waste does not contain any ,. <br />1 000 P.P.M. total halides, orcontaines any P.C.B's. <br />GENERATOR AUTHORIZED <br />DRIVER / SIGNATURE r e j <br />SIGNATURESERVICE <br />_._- -- <br />SIGNATURE .' -- --..ESTOPAYALLLEGALF�ESIF <br />CHARGE. STTOMER AGR E <br />TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5% <br />COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br />transported to facility that is required to comply <br />American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may be <br />i <br />federal regulations applicable to management of used oil, but that is not required to comply with the more stringent requirements applicable to hazardous <br />those more stringent requirements, and some out-of- <br />with <br />waste management facilities. California facilities that handle or process used oil are required to meet <br />certifications of tank integrity, and financial assurances for closure and <br />state facilities that process used oil also meet those requirements, engineering <br />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 />accidental releases. <br />stringent requirements. <br />This notification is for information purposes only. Date <br />Driver signed DateGenerator signed <br />certifies that the established a program to reduce the volume or quantity and toxicity of the hazardous <br />generator -has <br />By signing the invoice the generator <br />waste to the degree, as determined by the generator, to be economically practicable. <br />that American Valley will submit confirmations for (certain waste streams) to the generator <br />By both parties signing this invoice it will serve as an agreement <br />that their waste has been transported to a license treatment or transfer facility. <br />DISPOSAL/ RECYCLING FACILITY <br />O RAMOS ENVIRONMENTAL SERVICES <br />O RIVERBANK OIL TRANSFER <br />1515 SOUTH RIVER ROAD • W. SACRAMENTO, CA 95691 <br />5300 CLAUS ROAD • RIVERBANK, CA 95367 <br />916-371-5747 • EPA # CAD044003556 <br />209-863-8181 • EPA # CAL000190816 MPC 110120 <br />