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0 AMERICAN VALLEY 92176 <br /> WASTE OIL, INC. Invoice Number: <br /> P O. Box 340 Delhi, CA 95315 <br /> .---.PH. 1-80.0-732-4645, • FAX2-09-668-3880 <br /> EPA. CAL000827878 <br /> BILL TO: . UST JOB SITE:ION FFi S'fRUCT N Invoice Date: <br /> 5 E.WATERLOOD 4945WATERLOO <br /> STOCKTON,CA 95215 STOCKTON CA 95205 <br /> les' p:Steve <br /> Phone Customer PO. Terms EPA# <br /> 209-931'137' 38 GENE Net 15 Days CATOD0613968 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE. AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 00 L63 . <br /> e <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 22-3, <br /> NON Hazardous Waste Liquid �, , f � `� ' <br /> �� � t <br /> Trinity Heavy Duty premixed Recycled Antifreeze {, <br /> nity Extended Life premixed Recycled Antifreeze <br /> saEVJL-'`+vE it Vit` <br /> ity Case Goods CCaiE m , <br /> Truck Wash�Out <br /> Truck Time <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all.legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have--not mixed this waste with any other waste,.that the total halides are less than 1000 RRM;and that the waste does not <br /> contain any"P.C.B's. I further agree to accept the additional charges for legal disposal if the waste is over 1000 P.P.M.total halides;or contains any P.C.B's <br /> Generator's Certification: By signing I certify that I have a program in place to reduce the volume and toxicity of hazardous waste generated to the degree <br /> have determined to be economically practicable. <br /> By both parties signing this invoice it will serve as an agreement that.American.Valley,Waste Oil will submit confirmation for(certain waste streams)to the <br /> generator that their•waste has been transported to a licensed treatment or transfer facility. <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 but-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 rrCanagement standards and not these more <br /> stringent requirements. <br /> This notification is for information purposes only. <br /> DRIVER GENERATOR AUTHORIZ-D <br /> SIGNATURE SIGNATURE SIGNATURE <br /> POSA / REQ LING FACILITY O NAME: <br /> DK DIXON ADDRESS: <br /> O RAMOS ENVIRONMENTAL SERVICE <br /> 7300 CHEVRON WAY 1515 SOUTH RIVER ROAD CITY/ST: <br /> DIXON, CA,95620 W.SACRAMENTO, CA 95691 <br /> 707-693-6008 PHONE: <br /> 916-371-5747. <br /> EPA#CAT080012602 EPA#CAD044003556 EPA#: <br /> MPC(1012009) <br />