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i� Ll <br /> AMERICAN VALLEY 13 1U- 94 <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 /> CE:NIRALCAL IF. FRAG IION <br /> BILL TO: 2201 W. WASHINGTON ST# 12JOB SITE• CENTRAL CALIF TRACTION <br /> STOC'KTON CA 95205 1645 CHEROKEE Invoice Date: <br /> STOCKTON, CA 96205 <br /> 3 SAO SCH <br /> Sales Rep Felix. <br /> Phone479-3252 GERRY Customer P.O. TermsNet 30 Das EPA# <br /> Y CAL000200959 <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST QUANTI <br /> WASTE <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133HFRI_TH f�F AnT�133P <br /> NT <br /> Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> r <br /> PRICES,WE HAVE BEEN FORCED TO <br /> CHANGE PRICING FOR WASTE OIL ANL) <br /> Fit I'EIT PICK U <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 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, <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 volume 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 I can afford. <br /> By both parties signing this irfvoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the generator <br /> that their waste has beQ " ansportecl to a licensed treatment or transfer facility. <br /> GENERATOR1 <br /> DRIVER AUTHORIZED\, ..... <br /> SIGNATURE: DATE: SIGNATURE: ' + DATE: ' <br /> DISPOSAL / 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(6/2013) <br />