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AMERICAN VALLEY <br /> ' t.r l'V�►+ 4 5 0 6 7 <br /> WASTE OIL, INC. MAY 2 6 20151nvoice Number: <br /> L- _ � <br /> P. O. Box 340 • Delhi, CA 95315 ''` "°�'�' <br /> PH. 1-800-732-4645 • FAX 209-668-3880 - ��'`•'"'�� E��.. ` <br /> EPA#CAL000827878 EPAX CAL000416714 <br /> WASTE RECOVERY WEST JOB SITE: WASTE RECOVER t ..EST I oice Date: <br /> BILL TO: 4554 S.EL DORADO ST 4654 S.EL DORADO ST <br /> STOCKTON,CA 95206 STOCKTON,CA 952D6 <br /> Sales Rep <br /> Phone916-813-4704 RICARDO Customer P.O. TermsNet 30 Days EPA#CAL000396588 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE 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 /> Qk0%%k&QM0 -ABSORBENTS& DIL /y <br /> Lk <br /> o/ STcr 5$. 7 <br /> TERMS: Invoices over 30 Days are subject to a 1. /a service charge. Customer agrees to pay all legal fees 0 court action AL <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 1 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 srr all 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 ca ri afford. <br /> By both parties signing t - nvoice it)01 serve as an agreement that American Valley Waste Oil will submit confirr iation for(certain waste streams)to the generator <br /> that their waste has en transpo d to a licensed treatment or transfer facility. ! <br /> �DA <br /> GENERATOR/ <br /> DRIVER A HORIZED }�SIGNATURE: _— ' NATURE: V✓ y GATE: <br /> DISPOSAL/ RECY <br /> �'JQ FACILITY <br /> O DK-DIXON = O CFR O UNITED ENTERPRISES CORP <br /> 7300 CHEVRON.VOW 2035 E.15TH ST. 11190 PENROSE ST. <br /> DIXON, CA 9560 LA,CA 90021 SUN VALLEY,CA 91352 <br /> 707-693-60p' 213-746-0237 818-787-2649 <br /> EPA#CAT080012602 EPA#CAL000270577 EPA#CAL000379059 <br /> MPC(6/2013) <br />