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' ;. AMERICAN VALLEY <br /> RECVCLE-h. WASTE OIL, INC. Invoice Number: <br /> P. 0. Box 340 * Delhi, CA 95315 <br /> PH, 1-800-732-4645 - FAX 209-668-3880 <br /> EPA. CAL000827878 <br /> Invoice Date: <br /> BILL TO: JOB SITE: <br /> PhoneCustomer P.O. Payment Terms EPA# <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 <br /> RCRA HAZARDOUS WASTE LIQUID 343 <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> INITY HEAVY DUTY 50/50 <br /> CYCLED ANTIFREEZE N/A <br /> NON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE. CUSTOMER AGREES -D <br /> t NECESSARY TO COLLET THIS IN <br /> TO PAY ALL LEGAL FEESdF COU.f3T ACTION BECOMES NECESSA VOICE. TOTAL <br /> DRIVER GENERATOR,:, <br /> SIGNATURE <br /> SIGNATURE <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 aoci- <br /> dental 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 strin- <br /> gent requirements. <br /> This notification is for infojrnatjo A urposes only. <br /> y Date j,. <br /> Driver signed— Z.. <br /> tor-sign ed X <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 /> their waste has been transported to a license treatment or transfer facility. <br /> DISPOSAL/ RECYCLING FACILITY <br /> 0 RIVERBANK OIL TRANSFER 0 RAMOS ENVIRONMENTAL SERVICES <br /> 5300 CLAUS ROAD -RIVERBANK,CA 95367 1515 SOUTH RIVER ROAD-W. SACRAMENTO,CA 95691 <br /> 209-863-8181 -EPA#CAL0001 90816 916-371-5747•EPA#CAD044003556 <br /> MPC(412003) <br />