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AMERICAN VALLEY 148412 <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#CAL000416714 <br /> GARCHA TIRE REPAIR <br /> BILL TO: 1501 W CHARTER JOB SITE: 1501 HAW. TIRE <br /> RFR+� Invoice Date: <br /> STOCKTON,CA 95206 STOCKTON,CA 95206 <br /> Rep <br /> f2OMa-21540100 l�SV 1 ustomer P.O. Terms EPA# t:AL000�02685G DESCRIPTION WASTE MANIFEST ANTITY PRICE AMOUNTCODE <br /> Liquid Used Oil/Mixed Oils 221 <br /> Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used Oil Filters <br /> HAZ WASTE PICK UP ABSDRBENTS AND OIL --SEP.1 d_ <br /> 550 STEEL UN CERT <br /> Jabs Tax �... <br /> TERMS. Invoices over 3o Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have not mixed any of to waste described above with any other hazardous waste,the total halide content is LESS than 1,o00 ppm,and the <br /> waste does not contain any POBs. have complied with to requirements of the applicable carems.used oil management regulation to determine this is true.I agree to <br /> accept the additional charges for the disposal of Mis waste it the information I have provided about this waste is incorrect. _ <br /> Generator's Certification:By signing I canny that n 1 am a large quantity generator I earthy that I have a program in place to reduce the volume and Io usiN of waste gmarat- <br /> ed to the degree I have determined to be economically affordable and that I have tasseled fie practicable method of treatment,storage,or disposal comently available to me <br /> which minimizes the present and future threat to human life and the environment:Or.If I am a small quantity generator.I have made a Good faith effort to minimize my waste <br /> generation and select the waste management method that is available to me that I can afford. <br /> American Valley Waste Oil hereby advises the above Generator that generators shipment of used pit may be transported 10 a facility that w required to comply with federal <br /> regulations applicable to management of used aii,but that Is not required to comply with the more stringent requirements applicable to haeardous waste management factu- <br /> res.Calhoria facilities that handle or process used m11 are required to meet lose more stdrgent requirement,and Some put-of-state facilities that process used oil also meet <br /> Mose requirements,engineering cemmcations of tank imagery.and financial assurances for closure and accidental releases.Itis lawful to send used all to out of state facNtree <br /> Met comply only with federal used oil management standards end rot these more stringent requirements. <br /> This notifiastan Is for information purposes only. <br /> By both parties signiri g4iis invoice a will serve as an agreement that Amencan Valley Waste Oil will submit confirmation for(certain waste streams)to the generator road Mx <br /> waste has been tledtpprte re ii licensed treatment or transfer facility, <br /> ERATOR1 <br /> DRIVER --:fir �7///�' ORIZED p <br /> SIGNATURE: - - -- DATE:/ ` C"CUCC !!! NATURE:�.C7 DATE: <br /> L/ N FA ILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.15TH ST 1640 N.BROADWAY <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 IA,CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 707-693-6008 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CATOM12602 EPI CAL0003936BO EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br /> MPG QW16) <br />