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AMERICAN VALLEY* £ 3 <br /> WASTE OIL, INC. <br /> � ^ .. Invoice Number: <br /> P. O. Box 340 Delhi, CA 95315 <br /> %Y PH. 1-800-732-4645 FAX 209-668-3880 <br /> * ` EPA. CAL000827878 -44 <br /> r <br /> Invoice Date: <br /> BILL TO: J ." <br /> OB SITE: F&H CONSTRUCTION . <br /> F&H CONSTRUCTION <br /> 4945 E. WATERLOO RD 4945 WATERLOO <br /> STOCKTON CA 952* ' <br /> r <br /> , <br /> , <br /> � t1"1 �j^e` <br /> .t <br /> 0 <br /> Phone , � ; Customer P.O. Payment Terms EPA# <br /> 209-931-3738 GENE �; �; CAT000613968 <br /> ,1e X a, Y <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 /> 4', RCRA HAZARDOUS WASTE LIQUID 343 ' ' <br /> OILY WATER, NON RCRA HAZARDOUS <br /> WASTE LIQUID 221 <br /> TRINITY HEAVY DUTY PREMIX <br /> ECYCLED ANTIFREEZE N/A <br /> ON HAZARDOUS WASTE LIQUID <br /> TRUCK TIME N/A <br /> GREASWEEP N/A x el-'14 <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 TOTAL <br /> 1000 P.P.M.total halides,or containes any P.C.B.'s. <br /> DRIVER GENERATOR/AUTHORIZED <br /> SIGNATURE - SIGNATURE I 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 re <br /> as' 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 requir <br /> nem nts. <br /> This otificatiotei rmatio urposes on � <br /> ly. � W <br /> _ <br /> Driver signed D 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 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#CAD044003556 <br /> MPC(10/2( <br />