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AMERICAN VALLEY <br />WASTE ®IL, 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 />..i ` , <br />Invoice Date: <br />TO: JOB SITE: r:"LtllF'!t; TOWINGPACIF IC'9"I?>/V!N%;; <br />i4-14 EL FINAL DIR 1444 EI.. aINA!_ DR <br />tw(t7t;:KTON. CA 9! 5 ONE TAIM, IP! 1'AF (.`; r,', f':fP.!! it'd SHOP <br />STCCKTON, GA t?5205 <br />1 WK Olt.:ANK AN <br />Phone <br />Customer P.O. <br />Payment Terms <br />EPA# <br />_i64. -0E116 MIK1 <br />Nek 3t.� i38V s <br />CALOl�.)'?:r" 5 <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 />! ,A <br />_ _ <br />P✓p <br />OILY WATER, NON RCRA HAZARDOUS <br />WASTE LIQUID <br />221 <br />TRINITY HEAVY DUTY PREMIX <br />RECYCLED ANTIFREEZE <br />N/A <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />N/A <br />GREASWEEP <br />N/A <br />1 not y E- Aprided Life Prpfnix recycled Antffr <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 is over <br />TOTAL <br />1000 P.P.M. total halides;"or containes any P.C.B 's. <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 partes 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 �' O RAMOS ENVIRONMENTAL SERVICES <br />5300 CLAUS ROAD • RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD • W. SACRAMENTO, CA 95691 <br />209-863-8181 • EPA # CAL000190816 916-371-5747 • EPA k CAD044003556 <br />MPC (1012004) <br />