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AMERICAN VALLEY 55486 <br />' <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 /> P Invoice Date <br /> JOB <br /> x337 SHAW RD 441 V. p MOSSt ALS <br /> rur1[ F k r 7` Fr-r'ti ► C.tt"r'HFO , (-'A & <br /> Phone Customer PO Payment Terms EPA# <br /> `09 -461- 1006 X10 Ar, Net ;30 NAY3 <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 /> TRINITY HEAVY DUTY PREMIX <br /> RECYCLED ANTIFREEZE NIA <br />' HAZARDOUS WASTE LIQUID 110 <br />' TRUCK TIME N/A <br /> GREASWEEP N/A <br />' I hereby certify that t have not mixed this waste with any other waste,that the total halides are less than 10o0 P P m,and that <br /> the waste does not contain any PC B's I further agree to accept the addttional charges for legal disposal if this waste is over TO�q - <br /> 1000 P P M total halides,or containes an PC B's <br /> GENERATOR/AUTHORIZED <br /> DRIVER <br />' SIGNATURE SIGNATURE SIGNATURE <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5% SERVICE CHARGE CUSTOMER AGREES TO PAY ALL LEGA ES lF <br /> COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE <br />' American Valley Wash 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 a¢urances for closure and <br />' accidental releases It is lawful to send used oil to out of state facslibes that comply only with federal used o management s Herds and net these more <br /> stringent requirements <br /> This notification is for information DU cposes only <br /> Driver signed Date ` ``` - O ` Generator signed Date <br /> By signing the Invoice the generator certifies that the generator has established a program to reduce the volume or quantAy and toxicity of the hazardous <br /> waste to the degree, as determined by the generator,to be economically practicable <br /> AlIkboth 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 />' <br /> DISPOSAL / RECYCLING FACILITY w <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 9 CAD044003556 <br /> MPC(101200 <br />