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AMERICAN VALLEY 118934 <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#CAL000827878 <br /> M, %5320 <br /> BILL TO: JOB SITE: <br /> �t �` } �� Invoice Date: <br /> �` h�ttiitll Sales Rep, Amelcan Vdey <br /> 209-838-7470 HOBBY <br /> Not 30Days CAL000249027 . <br /> Phone Customer P.O. Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST QUANTITY PRICE AMOUNT <br /> WASTE <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 <br /> i <br /> Drained Used Oil Filters <br /> i <br /> f 3 <br /> TERMS: Invoices oar 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. Ithaa <br /> 8y signing I herby certify tib<I have not mixed any of the waste described above with any other hazardous waste,the total halide con <br /> and the waste does not conta y,PCBs.I have complied with the requirements of the applicable California used oil management regulation to determine this <br /> n artis <br /> true.I agree to accept th"dditional charges for the disposal of this waste if the information I have provided about this waste is incorrect. <br /> Generator's Certification:By sibning I certify that if I am a large quantity generator,I certify that I have a program in plaa to reduce the volume aro toxicity of waste <br /> generated to the degree I hA3p determined to be economically affgrdable and that I have selected the practicable method( <br /> 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 t can afford. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation fQr(certain waste streams)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> DRIVER ` GENERATOR/ <br /> SIGNATURE: AUTHORIZED <br /> DATE: SIGNATURE: <br /> ? <br /> .� DATE: <br /> DISPOSAL I RECYCLING FACILITY <br /> O DK-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 818-787-2649 <br /> EPA#CAT080012602 EPA#CAL000270577 EPA#CAL000379059 <br /> MPC(612013) <br />