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AMERICAN VALLE Y <br /> . � � »`���`� ice.'. 1448iJ1 <br /> G <br /> WASTE0!L' INC. Invoice Number: <br /> P.O. Box 340 • Delhi, CA 95315 MAY 2 6 20j'� <br /> PH. 1-800-732-4645 • FAX 209-668-388(�� <br /> EPA#CAL000827878 ``��`''� ������ <br /> BILL TO: WASTE RECOVER'WEST JOB SITE: WASTE RECOVERY WEST Invoice Date: <br /> 4654 S.EL DORADO ST 4564 S.EL DORADO SC <br /> STOCKTON,CA 95206 STOCKTON.CA 96206 <br /> Phone Customer P.O. TermsEPA# <br /> 31"13.4704 RK ;ARi Nei o'u Days CAL0 <br /> 0 <br /> 0 <br /> 396a88 <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 /> OiL COLLECTION FEE I ►n `1 <br /> Sails I ax <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 1 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 1 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 1 can afford. <br /> By both parties signing this invoice 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 been ransported to a licensed treatment or transfer facility. <br /> �' y' GENERATOR/ <br /> DRIVER // j' AUTHORIZED <br /> SIGNATURE: ,Gs� „v` DATE: / SIGNATURE: DATE:j '� <br /> QISPOSAL / RECYCLING FACILITY <br /> 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 />