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AMERICAN VALLEY" S4,7 r :; <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.CAL000627878 <br />1� IS•O"x' <br />Invoice Date: <br />a:f,r1IEI^ -rr�`AyINi JOB SITE: PACIFIC TOtNiPJG <br />11 <br />.(<t.4<i EL FINAL OR, 1444 E9_ PINAL DR <br />='T(X-XTON. CA 95205 ONE TANK W YARD & ONE IN SHOP <br />STOCK T Ort, CA 9,5205 <br />2lAiK.4Nr <br />.'�alac nian <br />Phone <br />Customer P.O. <br />Payment Terms <br />EPA# <br />zSig_,1�,,! liG h+IPfCE <br />Net :?? Davy <br />1:;A3_{1G{''(X?1:37 <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, ON <br />RCRA HAZARDOUS WASTE LIQUID <br />343 <br />1 f1K. <br />OILY WATER, NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />TRINITY HEAVY DUTY PREMIX <br />RECYCLED ANTIFREEZE <br />N/A <br />lv� Wc':�' <br />I <br />,. r7 <br />Z <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />Trinki P-rfevrjcKi Lite Premix recycled An ifreem! <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 wastIs is over <br />1000 P.P.M. total halides, or container any P.C.B_s, TOTAL <br />-_ <br />1 -` 7 <br />DRIVER ! GENERATOR/ AUTHORIZED <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 />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 RIVERBANK OIL TRANSFER ld RAMOS ENVIRONMENTAL SERVICES <br />5300 CLAUS ROAD • RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD • W. SACRAMENTO, CA 95691 <br />209-863-8181• EPA t! CAL000190816 916-371-5747• EPA CAD044003556 <br />MPC (101200. <br />