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' AMERICAN VALLEY 55677 <br /> WASTE OIL, INC. Invoice Number <br />' M P O Box 340 - Delhi, CA 95315 <br /> PH 1-800-732-4645 - FAX 209-668-3880 <br /> EPA CAL000827878 <br /> Invoice Date <br />'RBILL TO: ,SOB SITE: <br /> 1 <br />' Phone Customer PO Payment Terms EPA# ` Ii` v <br />' WASTE <br /> PRODUCT SHIPPING DESCRIPTION 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 /> HAZARDOUS WASTE LIQUID <br /> TRUCK TIME NIA <br /> GREASWEEP NIA <br /> 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/hat <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 ay er <br /> 1000 P P M total halides,or ntarnes any PC 13's ! TOTAL <br /> DRIVER tt I GENERATOR'AUTHORIZED SIGNATURE f SIGNATURE SIGNATURE t <br /> TERMS INVOICES OVER 30 DAYS ARE SUBJECT TOA 115% SERVICE CHARGE CUSTOMER AbREES TO PAY ALL LEGAL FEES IF <br /> COURTACTION 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 ad are required to meet those more stringent requirements and some out-ot- <br /> state facilities that process used oil also meet those requirements, engineenng certifications of tank iritegnty, 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 /> asts to the degree,as determined by the generator, to be economically practicable <br /> I <br /> parties signing this invoice it will serve as an agreement that American Valley will submit confirmations for(certain waste streams)to the generator <br /> I their waste has been transported to a license treatment or transfer facility <br /> DISPOSAL/ RECYCLING FACILITY <br /> RIVERBANK OIL TRANSFER 0 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(1Wpflp <br />