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AMERICAN VALLEY 52273 <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 /> s r �rr•r ' ' Is�i�1S r's' ; is �� <br /> Phone Customer PO Payment Terms EPA# <br /> iPw Ai I I6a f-11 3--. iii I e,% <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 /> CYCLED ANTIFREEZE NIA <br /> N HAZARDOUS WASTE LIQUID ! <br /> TRUCK TIME NIA <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 that <br /> the waste does not contain any PC 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 f _ _ -. _ -� <br /> SIGNATURE SIGNATURE / 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 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 I Date Generator signed �J ? a ^+ + ' 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 /> aste 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 /> at 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 /> I 5300 CLAUS ROAD• RIVERBANK, CA 95367 1515 SOUTH RIVER ROAD•W SACRAMENTO, CA 95691 <br /> 209-863 8181 •EPA#CAL000190816 916-371 5747• EPA 4 CAD044003556 <br /> MPC(101200 <br />