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AME1RICAN VALLEY i 5 u 4 E;8 <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#CAL000416714 <br /> FAR MIIN6I ON FRESH <br /> BILL TO: P.O BOX 3(W7 JOB SITE: P'aRMwe'reN FRESH Invoivon <br /> ce Date: <br /> STOCKTON,CA 913213 7745 FRONTAGE 99 RD WE.r.T <br /> PSTOCKION.CA 95215 <br /> X ARCH <br /> SBais Re f <br /> Phone Customer P.O. Terris EPA# <br /> 209-9$3.474JiM C.Q.D. ;AI01)Ot$9.4 u <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 l <br /> Co <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used-Ofl-Fi+ters - - ----- -- - --- - <br /> Oil <br /> .T-iD(-T st Ot!.]D <br /> Saks 7r,x <br /> TERMS: Invoices over 30 Days arc 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. /'..• r-; <br /> By signing I herby certify that I have not mixed any of the waste described above with arty other hazardous waste,the total hallde content Is LESS than 1,000 ppm,and the <br /> waste does not contain any PCBs.I have complied with the requirements of the applicable California used uil management regulation to determine this is true.I agree to <br /> accept the additional charges for the disposal of this waste if the information I have provided about this waste Is Incorrect. „s.,.,-- __ <br /> Generators C xuficutiwi:By signing I certify that If I sm a large quantity generator,I certify that I have a program in place to reduce the velurrts anQ 1�rXofly po,f waste general- 1 <br /> ad to the degree I have detemni ned to be economically affordable and that I have selected the practicable method of treatment,,stowoe,-egd l <br /> aille to me <br /> which minimizes the present and Allure threat to human Ilfe and the environment:Or,if I am a small quantity generator.I have made a Good(alth effort to minimize my waste <br /> generation and select the waste management method that Is available to me that I can afford. �r��' <br /> American Valley Waste 011 hereby adwsss the above Generator that generators shipment of used oil may be transported to a facility gnat Is M41E&1-2p9arltti federal <br /> regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facili- <br /> has.California facilities that handle or process Lead dl are required to meet those more stringent requirement,and some out-uf-state facilities that process used oil also meet <br /> those requirements,engineering certifications of tank integrity,and financial assurances for closure and accidental releases.It ii to to send used oil to out of state facilities <br /> management standards and not these more <br /> that comply only with federal used oil managestringent requirements. C ^ M ENTAL F <br /> This notifications for Information purposes only.By both parties signing tis Invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to(he'�dn59Fgibi that their <br /> waste has been lrangp?ted to a)lgensed treatment or transfer facility. r <br /> G -y ,.� GENERATOW- j <br /> DRIVER �' -, l; / AUTHORIZEDI <br /> SIGNATURE: - DATE ( -%;r./!. SIGNATURE: �n A"A DATE <br /> I, <br /> DISPOSAL/ RECYCLING FACILITY <br /> O DK-DIXON ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.15TH ST 1640 N.BROADWAY <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 LA,CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 707-693-6008 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA*CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br />