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AMERICAN VALLEY 55677' <br /> WASTE OIL, INC. Iw otce NLImbei <br /> P O Box 340 • Delhi, CA 95315 <br /> 0 PH 1-800-732-4645 • FAX 209-668-3880 <br /> EPA CAL000827878 <br /> Invoice Date <br /> BILL TO: )OB SITE: <br /> +(, i �S <br /> cls itc-i? stew, <br /> Phone Customer PO Payment Terms EPA# <br /> 201) 4r,7 1006 X10 AP Pie* iC► Dais, <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 LIQU I D 221 <br /> ON <br /> INITY HEAVY DUTY PREMIX <br /> ICYCLED ANTIFREEZE NIA <br /> HAZARDOUS WASTE LIQUID <br /> U <br />' TRUCK TIME N/A <br /> � <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,qnd t at i J <br /> the waste does not contain a y mP C B's I further agree to accept the additional charges for legal disposal if this wast is o�er � AA <br /> 1000 P P M total halidesli or, taes any P C B's ( T <br /> DRIVER �,j` /r GENERATOR/AUTHORI ED <br /> SIGNATURE SIGNATURE / SIGNATURE L! , <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TO A 1 5%SERVICE CHARGE CUSTOMER AGREES TO PAY ALI LEGAL FEES IF <br /> w <br /> OURT ACTION BECOMES NECESSARYITd`COi-LECTTHIS 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 /> ith 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-ot- <br />' state facilities that process used od 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 mora <br /> stringent requirements y,y*, 5 ,s <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 /> rite to the degree, as determined by the generator,to 15e,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 /> t their waste has been transported to a license treatment or transfer facility , <br /> , l..-DISPOSAL / RECYCLING FACILITY <br /> J 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 t0 CAL000190816 916-371-5747- EPA#CAD044003556 <br /> MPC 00120, <br />