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* AMERICAN VALLEY 136933 <br /> WASTE OIL, INC. Invoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 ' <br /> PH. 1-a00-7-3,2-4645 • FAX 209-668-3880 <br /> Jhfl�lpe G iC A# cAL000s27s7f3 �I - <br /> Q,it � JOB SITE: IDEALEASE <br /> BILL TO: <br /> �C� +'`� 11375.STOCKTON ST Tnv ice Date: <br /> STOCKTON, CA 95206 <br /> �IsC�I �GaL u�2�II 1WK3MAF1MFI <br /> l yl�"'1 - 3a 'SG 1 g' Sales Rep Steve <br /> Pho"209-9440909 JERRY Customer P.O. Terms Net30Days <br /> EPA# <br /> CAL000344064 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 00,273203G(3 <br /> Drained Used Oil Filters <br /> ) <br /> AUG <br /> MEN'AN <br /> ML <br /> CQ1TV r�C �OTI�GU+ <br /> Sales Tax <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge.Customer agrees to:pay all legal fees if court action TOTAL <br /> becomes necessary tocollectthisinvoice. <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 compliedwiththe requirements of the applicable California used oil management regulation to determine this is <br /> true-1 agree to accept the additional charges for the dispose I of thiswaste if the information l 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 have a programinplace to reduce the volume and toxicity of waste <br /> generated to the degree[have determined tobe economically afford able and that I have selected the practicable.method of treatment,storage,ordisposalcurrently <br /> available tome which minimizes the present and future threat to human Iife 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 tome that I can afford... _ <br /> By both parties signing this invoice it will serve as an agreement that American Valley Nste.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 /> � rf /r <br /> GENERATOR/ :j: �F� <br /> DRIVER AUTHORIZED .70-/ - <br /> SIGNATUR t - DATE: �� SIGNATURE: DATE <br /> L / <br /> ��P,QSAL / RECYCLING FACILITY <br /> DIXON 0 CFR 0 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 <br /> 707-693-6008 213-746.0237 818-787-2649 <br /> EPA#CAT080012602 EPA#CAL000270577 EPA#CAL000379059 - <br /> MPC(8/2013) <br />