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.j <br /> *AmERICAN VALLEY 9 <br /> RECEIVEL) WASTE 01; 'INC. Invoice Number: <br /> P. O.Box 340 - Delhi, CA 95315 <br /> MAY 19 2015 PH. 1,-800.732-4645 o FAX 209-668-3880 <br /> ENVIRONMENTAL EPA# CAL000627878 <br /> -,ILL TO: kJC&t-U nC0AVT%ACMIT JOB SITE: is Anvoic DO <br /> 90 L kb I 0"Ne t--Ir <br /> Ecj-c&-�C�) tcA c7`15'52D) <br /> Phone `R 0 =Customer RO. Terms EPA# <br /> — —r I <br /> P6I CaLUX) 14-<� <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANT PRICE AMOUNT <br /> I CODE it <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 310 112, <br /> NON-RCRA Waste Liquid Usec Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> TERMS: Invoices over 30 Days are subject-.a a 1.5%service charge. Customer agrees to pay alt.legal fees ii court action <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 Wide content is LESS than 1,000 ppm, <br /> and tt-e waste does not contain any PCBs.I have complied with the,-eqiiremeiAs of the applicable Califorria used oil management regulation to determine this is <br /> true.i agree to accept the additional charges far 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 n Place to reduce the volume and toxicity of waste <br /> generated to the degree I have determined tube economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently <br /> availaole tome whicF,minimizes the present and future threat tohuman I fe and the environment:Or,if i am a small quantity generator,I have made a good faith <br /> effort to minimize my uvasteger.eration and select the waste management method that is available tome that I can afford. <br /> By both parties signing this invoice it will serve as an agreement that AmEricanValley Waste 0 it will submit confirmation for(certain waste streari7�)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> AUTHORIZED <br /> DRNER SIGNATURE �TE. <br /> SIGNATURE: DATE: <br /> DISP SAL / RECYCLING-EA-CILITY <br /> 'DK-DIXON C) CFR 0 UNITED ENTERPRISES CORP <br /> /1,11173D0 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 EPAlf CAL000270577 EPAft CAL000379059 <br />