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AMERICAN VALLEY 130789 <br />WASTE OIL, INC. Invoice Number: <br />R-0. Box 340' Delhi, CA 95315 <br />13W,-4-1800-732-4645 - FAX'201.9-668-3880 <br />EPA# CAL00082787:8 <br />GAS WHOLESALEWHOLESALE <br />C&S ti HOLESALE <br />BILL TO 4199OIBRALt'OR JOB SITE: 4199 GIMALTC)R Invoice Date: <br />ISIOCK?ON, CA 95201, STOCKTON, CIE 95205 <br />Sates step <br />Phone (jq_?34-. 871, @E <br />Customer RO. <br />TermsNet30Days <br />EPA#CAL0o0332679 <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE'. <br />AMOUNT <br />WASTE <br />CODE <br />NOLO-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />�'C <br />A%1 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Drained Used Oil Filters <br />r I <br />PRIDE -30E HA1 E= BEEN FORCED To <br />CHANGE PRICING FOR WASTE OIL AND <br />FITT�ELl <br />c:)�2 <br />S, lir (�i <br />�W� <br />- C..-f-� . j✓' <br />TERMS: Invoices*er 30 Days are subject to a 1.5% service charge. Customer agrees to pay alhlegai fees if court action <br />TOTAL <br />becomes necessary to collect this invoice. <br />By signing i herby certify that I have not mixed any of'the waste described above with any other hazardous waste, the total halide content is LESS than 1,000 ppm, <br />and the waste does not contain any PCBs. I have compiled with the requirements of the applicable California used oil management regulation to determine this is <br />true. I agree to accept the additional charges for the disposal of this waste if the Information I have provided about this waste is incorrect. <br />Generator's Certification: By signing I certify that if I am a large quantity generator, I certify that I have a program in place to reduce the volume and.toxicity of waste <br />generated to the degree I have determined to be eco6rgically affordable and that I have selected the practicable method of treatment, storage, or disposal currently <br />available to me 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 <br />effort to minimize my waste generation and select the waste management method that is available to me that I can afford. <br />By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the generator <br />that their waste has been transported to a licensed treatment or transfer facility. <br />"GENERATOR! <br />DRIVER AUTHORIZED .,.. <br />".� <br />/ <br />SIGNATURE: 1.'?�`l:•o ,�i� r---.--.'� DATE:.. <br />.. SIGNATURE: f D E: <br />DISPOSAL / RECYCLING FACILI TO RECEIVE)_.' <br />-DK-DIXON Q CFR UNITED ENTERPRISES CORP <br />7300 CHEVRON WAY 2035 E. 15TH ST. 11190 PENROSE ST. <br />DIXON, CA 95620 LA, CA 90021 SUN VALLEY, CA 91352 SEP 0 S 2n15 <br />707-693-6008 213-746-0237 818-787-2649 <br />EPA# CAT080012602 EPA# CAL000270577 EPA# CAL000379059 <br />ENVIRnNgA;=hrr ► <br />`EA1--tr �r�nn+�.�r-�i�1UPC(6/2013) <br />