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16 AMERICAN VALLE10 <br />WASTE OIL, INC. <br />P. O. Box 340 * Delhi, CA 95315 <br />PH. 1-800-732-4645 * FAX 209-668-3880 <br />EPA# CAL000827878 <br />BILL TO: Kim, )� JC)AQQIN;'11'.-0 <br />A� JOB SITE: <br />P0 !30X` <br />"A 9.-41 <br />R? &- <br />Sa.� <br />120909 <br />Invoice Number: <br />1 -110-1 � <br />Invoice Date: <br />ep <br />Phone Customer P.O. Terms EPA# <br />NEt 30 Days <br />PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils T221 <br />NON-RCRA Waste Liquid Used Antifreeze 133 P� 1G7 <br />NON-RCRA Waste Liquid Used Oily Water 223 <br />Drained Used Oil Filters <br />42f) L-21 d Z/--` <br />4id 1141'17;� F-1yrilldd <br />SALL5 I AX - <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. customer agrees to pay all legal fees if courtaction <br />becomes necessary to collect this invoice. TOTAL <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 LE55than 1,000 ppm, <br />and the waste does not contain any PCBs. I have complied 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 economleally 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 beennspored to a licensed treatment or transfer facility. <br />GENERA <br />DRIVER✓AUTHOR'T122' <br />SIGNATURE: DATE: SIGNATURE:/ DATE: <br />DISPOSAL I RECYCLING FACILITY- V <br />0 OK-OIXON 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 />ERA# CAT080012602 EPA# CAL000270577 EPA# CAL000379059 <br />MPC (&2013) <br />MPC (&2013) <br />