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AMERICAN VALLEY 52597 <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 /> Invoice Date <br /> BILL TO: JOB SITE: <br /> Ut'V��tI�.�ET) �sl:,� f�,f`,C�','F <br /> Phone Customer P O Payment Terms EPA# <br /> - C1 P4 l€� I F s Pi t + l i -� r {�r i't� I t 4 <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 - 1 <br /> TRUCK TIME N/A <br /> GREASWEEP NIA <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 th6t <br /> the waste does not contain any P C 13/s 1 further agree to accept the additional charges for legal disposal If this waste is 9ver <br /> 1000 P P M total halides,or contarnefan #A's T T <br /> DRIVER ' �_ GENERATOR/AUTHORIZEDL. <br /> uJ <br />' SIGNATURE - -- — SIGNATURE SIGNATURE f J <br /> TERMS INVOICES O,Vb R 30 DAYS ARE SUBJECT TO A 1 5%SERVICE CHARGE CUSTOMER A REE5 TO AY ALLE6AL 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 /> 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 /> O RIVERBANK Olt_TRANSFER a 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{1012004 <br />