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AMERICAN VALLEY WASTE OIL, INC. Invoice Number: P.O. Box 340 • Delhi, CA 95315 PH. 1-800-732-4645 • FAX 209-668-3880 EPA#CAL000416714 FARBOX 3066 FRESH BILL TO: P.O Cox N.C JOB SITE: PARM',A 999 FRESH STOCKTON.CA 95213 7736f-:A-99 nvotce Date: 81'OCKTON, CA 95215 X:ARCH Saks Rep Phongog-gKg.gyod,H,M Customer P.O. Terms EPA# C O.Q. l",AL.00028986.5 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTrFY PRICE AMOUNT CODE NON•RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 NON-RCRA Waste Liquid Used Oily Water 2�3 Drained Used Oil Filters HAZAROCUS WASTE PICK-UP,REFRIGERATION IL � f� T -- DE err*L",;LHEAL 2t 16 TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL - becomes necessary to collect this invoice. -�-r• t'f% By signing I herby certify that I have not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,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 true.I same to accept the additional charges for the disposal of this waste If the inforrnation I have provided about this waste Is incorrect. Generator's Certigcatbn: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 general- ad to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently 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 effort to minimize my waste generation and select the waste management method that is available to me that I can afford. American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility that is required to comply with federal 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- ties.California facilities that handle or process used 011 are required to meet those more stringent requirement,and some out-of-state facilities that process used ail also meet those requirements,engineering certifications of tank Integrity,and financial assurances for closure and accidental releases.It Is lawful to send used oil to cut of state facilities that comply only with federal used oil management standards and not these more stringent requirements. This ratification is for Information purposes only. By both parties signing this Invoke it will serve as an agreement that American Valley Waste Oil will submit confirmation far(certain waste streams)to the generator that their waste has been transported to a licensed treatment or transfer facility. r) /f/��jy % r GENERATOR/ DRIVER �/w,t-ev' /v- �, AUTHORIZED .-e., ':� SIGNATUREf/ Ic�� _ Fes' DATE: I^-- p �.1 SIGNATURE: / DATE DISPOSAL/ RECYCLING FACILITY O DK-DIXON 0 ASBURY ENVIRONMENTAL 0 RIVERBANK OILTRANSFER 0 CFR 0 GLOBAL MATERIAL MGMT 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.15TH ST. 1640 N.BROADWAY DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA95367 LA,CA 90021 STOCKTON,CA 95205 707-693-6008 707-693-6008 209-863.8181 213-746.0237 818.770.2577 EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 MPC(72016)