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57635 <br />0 AmERICANNALLE4 <br />- Invoice Number: <br />-.WASTE 1L ; l C. <br />P. O. Box 340 • Delhi, CA 95315 <br />PH 1-800-732-4645 I, FAX 209-668-3880 <br />EPA. CAL000827878 .� <br />Invoice Date: <br />JOB SITE: <br />Dill, i ., <br />QUALITY AUTO 'REPAIR <br />QUALITY AUTO REPAIR 12fi HAR:DTNG `4TAY <br />4 A <br />` 7 2 46—A --F, HARDING S"POCI+n['ON, CA' 95205 <br />S TOCKTON r CA 95205 . <br />i - Payment Terms qa <br />Customer P.O <br />Phone _ <br />i' MANIFEST <br />QUANTITY PRICE AMOUNT <br />WASTE S <br />PRODUCT SHIPPING DESCRIPTION CODE <br />iS ' 11 <br />USED OIL NON RCRA HAZARDOU 221 <br />WASTE.LIQUID . <br />USED AUTOMOTIVE ANTIFREEZE, NON 343 <br />RCRA HAZARDOUS WASTE LIQUID <br />OILY WATER, NON RCRA HAZARDOUS - 221 ` <br />WASTE LIQUID <br />TRINITY HEAVY DUTY PREMIX N/A ? L <br />RECYCLED ANTIFREEZE <br />' .NON HAZARDOUS WASTE LIQUID <br />a <br />r N/A <br />TRUCK TIME <br />GREASWEEP'. <br />hereby cern that I have not mixed waste with any othwaste, e adds onai charges forare <br />legal disposal i�f this waste s over, L <br />1 her y b <br />the waste does not contain any P.C.B.'s: I further -agree -t9 a p <br />f 1000 PP.M total Halides, or container an <br />PC B.'s. GENERATOR AUTHORIZED <br />I <br />DRIVER s:: SIGNATURE SIGNATURE _ <br />t' `SIGNATURE LEGAL FEES IF <br />._ SERVICE CHARGE. CUSTOMER AG <br />w <br />TERMS'IN VER 30 DAYS ARE SUBJECT <br />"COURT ACTION BECOMES coml <br />NECESSARY TO COLLECT THIS INVOICE. <br />ed:oil but that is not required to comply with the more stringent requirements applicable to hazardo <br />i` <br />American Valley Waste Oil hereby advises the above Generator the Generators shipment of used oil may transported to a facility that is require a ardo <br />Am l�cabie to management of us rin ent requirements" nd some out- <br />with federal regulations api . nd financial assur ces for closure a <br />waste.management facilities. California facilitie's'that han ile or process used -oil are required s of tat k in a •mo <br />i onl with federal use oil anagement sta rds and not these m< <br />state facilities that process used oil also meet those requirements; engineering certifications d tank inte <br />accidental releases. It is lawful to send used oil to out-of-state state facilo4ies tha comp <br />I stringent requirements; only. <br />y This notification is for information Date <br />! ®ate ` Generator signed v e or quantity and toxicity of the hazard, <br />a Driver signed hed a program t r r <br />practicable By signing the i oice the generator cede® eneaatoG__ o, reconom[ca11Y P. <br />waste to the degreer.as determined. by. g . at American Vailey wid submit confirmations for (certain waste streams) to the gene <br />f reement that <br />By both parties signing this invoice it will serve as ag <br />that their waste has been transported 4o a IiGense treatment or transfeifacility <br />DISP®SAL RECYCLING FAC _ <br />` 4RAMOS ENVIRONMENTAL SERVICES <br />RIVERBANK OILTRANSFER 1515 SOUTH RIVER ROAD • W SACRAMENTO, CA 95691 <br />5300 CLAUS ROAD • RIVERBANK, CA 95367,916-371-5747 •EPA # CAD044003556 <br />209-863-8181 0 EPA # CAL000190816 <br />