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AMERICAN VALLEY 126421 <br /> WASTE OIL, INC.. Invoice Number: <br /> P.O.Box 340 a Delhi. CA 95315 <br /> PH. 1-800-732-4645 a FAX 209.688-3880 <br /> EPA#CALOODS27078 z <br /> FARMINGTONFRESH FA5FRONTAGE99RRMINGTON FRESH <br /> (DILL TO: a o sox 30667 JOB SITE: 7735 FRONTAGE 99 15 WEST Invoice Dane: <br /> S T OCKTON. CA 35213 X ARCHON,CA 95215 <br /> X ARCH <br /> Sales Rep <br /> "9209-9839700 JIM Customer P.O. lTerms EPA» CAL0002844b'i <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST OUANTIT�ICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used OIVMIxed Oita 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oil Wets 40 <br /> _-- ,� [s fJGZI S6o L,�s2 <br /> Drained Used Oil Fitters <br /> TERMS Irwoices Quay 30 Daya ere sublea toe 1 S%service charge. Customer agrees to pay ell legal foes if court notion TMAIIP <br /> becomes naticageseary to dollact that Irtvuda. <br /> By ugning I herby,certify that I have not mixed any of the waste des,rihed above with any other hazardous waste,the total hande content 1s LESS than 1,000 ppm, <br /> and the waste does not contain any PCBs.I have complied with the requiremenu of the applicable California used oil management regulation to determine this is <br /> true 1 agree to 4ccept the additional charges for Me dlaposal of this waste Ifthe Information I have provided about this westa Is inmrtea. <br /> Generator s Cemficabon By signing 1 unify that 1f I am a large quantity generator.I certify that l have a program In place to reduce the volume and toxicav of wane <br /> generated to the degree I have determined to be economlcally affordable and that I have selaae0 the praccicable method of treatment,storage,or disposal currently <br /> available W rM wlech mehmues the Present and future threat to human Isle and the environment Or,it I am a smail quantity generator,I have made a good faith <br /> effort to minimize my waste generation and select the waste management method that 1s ava Mable to me Mat I can afford. <br /> By both wnwi signing this invoice it will sem as an agreement that American Valley Waste 01 will submit confirmation for(certain waste streams)to the generator <br /> that thea waste has been transported to a IKensed treatment or transfer facility <br /> GENERATOR <br /> DRIVERAUTHORIZED !- �77't <br /> SIGNATURE. ' � _ SIGNAtURE r�'f�C-�T _ IMiE ((..���a-' <br /> DISPOSAL/ RECYCLING FACILITY 777 <br /> viOR•DIxON O CFR O UNITED EN ERPRIs"S P <br /> 7300 CHEVRON WAY 2035E 15TH ST �k71 O PEN SE=�� <br /> DIXON,CA 96620 I.A.CA 90021 S ���/// <br /> 707-693-6006 213746-0237 618-767.2649 <br /> EPA$CAT080012602 EPA#CAL000270677 EPA#CAL <br /> WC lh2.131 <br /> Utt-r7n i HENT <br />