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AMERICAN VALLEY �;�,, ;;,� �;_144932, <br /> ' WASTE OIL, SNC. Invoice Number: <br /> MAY 2 6 2016 <br /> P. 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> 76 �zt GA.I ui 4—*,'1 <br /> WAST E REWVERY WESIJOB SITE: VNASTF REC^�OVERY WEST jtS� voice Date: <br /> BILL TO: 4564 S EL DORADO ST 455415 EL DORADO S <br /> S?OCKTON CA 95206 STOCKTON CA 95206 <br /> Sales Rep <br /> Phoneyl6-813.47(34 RICARUU Customer P.O. Terms Net 30 Days EPA#CAL00039658tx <br /> PRODUCT SHIPPING DESCRIPTIONWASTE MANIFEST OUANTITY PRICE I AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> 0U <br /> LIN5G PAJL VV/ML IAL.SHAVING <br /> JP4 BOX <br /> i <br /> g pay g TOTAL <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to a all legal fees if 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 halide content is L 55 than line this is <br /> ppm, <br /> and the waste does not contain any PC5s.l have complied with the requirements of the applicable California used oil management regulation to determine t <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 /> Generators 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 invoice it will serve as an agreement that American Valley Waste Cil will submit confirmationfor(certain waste streams)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> AUTHORIZED <br /> __ <br /> DATE: <br /> DRIVLeR _ <br /> DATE: SIGNATURE: <br /> SIGNATURE: <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 /> 213-746-0237 818-787-2649 <br /> EPA# CAT080012602 0EPA#CAL000270577 EPA#CAL000379059 <br /> PA# <br /> MPC(6/20 <br />