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10 AMERICAN VALLE` <br />WASTE OIL, INC. <br />BILL TO: JIh1THORPEOIL INC <br />P <br />J 6CX357 <br />LODI, CA 95241 <br />P. O. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 a FAX 209-668-3880 <br />EPA# CAL000827878 <br />JOB SITE: .SAN JOAQUIN RTD <br />1533 LINDSEY <br />STOCKTON, CA 9520.5 <br />Sales Ran, Siwe <br />122052 <br />Invoice Number: <br />I voice bate. <br />C/%v <br />Phone <br />Customer P.O. <br />Terms <br />EPA# <br />209-462 4581 <br />N�'t jti Days <br />(7ff/w j3 <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Q <br />Drained Used Oil Filters <br />—r <br />VI <br />u /¢ <br />_k <br />�/�11KS <br />SA LES 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 <br />becomes necessary to collect this invoice. <br />TOTAL <br />By signing I herby certify that 1 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 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 1 have provided about this waste is incorrect. <br />Generator's Certificatfoq: 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 economically 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/ r <br />DRIVER AUTHORIZED <br />SIGNATURE: DATE: & <br />DISPOSAL / RECYCLING FACILITY <br />O-M-DIXON O CFR O 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 818-7874649 <br />EPA# CAT080012602 EPA# CAL000270577 EPA# CAL000379059 <br />MPC (8.2013) <br />