Laserfiche WebLink
AMERICAN VALLEAE, C VEL119833 <br /> WASTE OIL, INC. 1. 8 2013 Invoice Number: <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3FBVIRONMENTAL <br /> EPA# CAL000827878 HEALTH DEPARTMENT <br /> BOB ALLEN <br /> BILL TO: VAN DE POL JOB SITE: 2904 BEYER LN. <br /> P.O BOX 1107 STOCKTON,CA 95201 Invoice Da e: <br /> STOCKTON,CA 95201-11Q7 <br /> Sales Rep: Steve <br /> Phone Customer P.O. Terms EPA- <br /> 209-931-3535 <br /> # <br /> 209 931-3535 BOB Net 30 gays CADW2060619 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 l�c.fl.j <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <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 to collect this invoice. <br /> By signing I herby certify that 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 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 voldme 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 l can afford. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmatioA for(certain waste streams)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. i <br /> GENERATOJk— J , <br /> DRIVER AUPOR 2ED J� �✓' <br /> SIGNATURE: DATE: � I-f SIGNATURE: DATE: <br /> DISPO AL / RE.CY LING FACILITY <br /> 1 DK-DIXON O CFR O UNITED ENTERPRISES CORP <br /> 300 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(6/2013) <br />