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BILL TO: <br />QUALITY:A41TO REPAIR <br />1246-A Ei.-HARDING <br />STOCKTON, CA 95205 <br />Phone Customer P.O. <br />209-462-1110 ALAN <br />PRODUCT SHIPPING DESCRIPTION _T <br />is AmERICAN VALLO <br />. WASTE OIL, INC. <br />R 0. Box 340 - Delhi, CA 95315 <br />PH. 1-800-732-4645 ? FAX 209-68-3880 <br />EPA. CAL000827878 <br />USED OIL NON RCRA HAZARDOUS <br />WASTE LIQUID <br />USED AUTOMOTIVE ANTIFREEZE, NON <br />RCRA HAZARDOUS WASTE LIQUID <br />OILY WATER, NON, RCRA HAZARDOUS <br />WASTE LIQUID <br />TRINITY HEAVY DUTY PREMIX <br />RECYCLED ANTIFREEZE <br />NON HAZARDOUS WASTE LIQUID <br />TRUCK TIME <br />GREASWEEP <br />FUEL SU R CHARGE <br />JOB SITE: <br />QUALITY AUTO REPAI <br />1246 HARDING WAY <br />CA 95201 <br />68342 <br />Invoice Number: <br />Invoice Date: <br />t JL ir3 S" <br />0 - Cc, (-�-P: <br />Payment Terms EPA# <br />C.O.D. CAL000120780 <br />WASTE MANIFEST- <br />-CODE <br />I _ QUANTITY PRICE AMOUNT <br />221 D c/-' <br />N/A <br />N/A <br />I hereby certify that I have, not mixed, this waste wi other waste, that -are less than the total halides an 1,00Q RP.M.; and that <br />the waste does not contain. an to Pt the additionalI charges for legal disposal y P.C.B.'s. I furthe accept <br />1000 P RM: total halides, or containes an RC if this waste is over <br />TOTAL <br />DRIVER GENERATOR AUTHORIZED <br />SIGNATURE <br />SIG'NATURE/,5(GNATURE <br />TERMS: INVOICES OVER 3 E SUB, _ <br />ECT TO 4 11,�504p SE9VICE CHARGE. CUSTOMER. AGREES TO PAY ALL LEGAL FEES IF <br />COURT ACTION BECOMES NECESSARY TO CPLLECTTH.IS 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 <br />with federal regulations applicable to managemen I t of used oil but that Is not re y t to comply <br />required to. comply with the more strings t requirements <br />applicable to hazardous <br />A�ad4 in�agement facilities. California facilities that handle' or process a are raqujed to meet those more drigent requirements, and some out -of - <br />Iso meet tliqse req n r <br />state facilities thafproc�ss used oil a' uifqmqnts, engineering g certifications <br />of <br />used <br />a and <br />accidental reout-of-stateg t comply only <br />with fedi tank integrity and financial assurances for closure and <br />leases. It is lawful. to send used oil to facilities that <br />)ral used of anagement standards and not these more <br />stringent requirements. <br />This notification is for information purposed only. <br />Driver signed <br />Date n C rsignedGenarntn <br />_Date <br />By signing the invoice the generator certifies, that the. generator has established a program <br />to 8 volume or quantity and toxicity of the hazardous <br />a volume <br />waste to <br />the degree, as determined by the generator, to be economically practicable. <br />By bothparties, signing this invoice it will. serve as an a_9'!9_9Tent that American. Valley will subm4onfirmations for (certain waste streams) to the generator' <br />that their waste has been transported to a license treatment. <br />or transfer facility. <br />y. <br />DISPOSAL RECYCLING FACILITY ' ' - <br />(2l`-nMRBAN,KOIL 'TRANSFER ORAMOS ENVIRONMENTAL SERVICES <br />5300 CLAUS ROAD, - RIVERBANK, CA, 95367 1515 SOUTH RIVER ROAD 9 W. SACRAMENTO, CA 95691 <br />M-863-8181 -1 EPA # C <br />AL000190816 916-371-5747 * EPA # CAD044003556 <br />WC (I WON) <br />