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a a AMERICAN ALLEY17952-1 /\/ �T 1 INIC T -oi�4 Numbet: 1WS N E 1L, ,I I��I,JI lY b P O, Box 340 •Delhi, CA 95315, PH. 1-800-732-4645 • FAX 209-668-3880 EPA#CAR000272302 BILL TO: 1 x'E � ,v r, . tet s Invoice Date: r & -x 404 .., �*2--3..,'' r s 4 C ha F Phone Customer P.O. Terms EPA# t �N iNICA, at 0.0� � PRODUCT SHIPPING DESCRIPTION MANIFEST Q ITY PRICE AMOUNT WASTE CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 NON-RCRA Waste Liquid Used Oily Water , 223 Compliant Drained Used Metal tail Filters � 11 TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL becomes necessary to collect this invoice, By signing I herby certify that I have not mixed anyof the waste described abovo with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the wast";does not contain any PCBs,i have complied with the requlrements of the applicable California used oll"management regulation to determine this is true.I agree to i accept the additional charges for the disposal of this waste if the Information i have provided about this waste'ls'incorect. 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 generat- € ed to the degree I have determined to be economically affordable and that I have selected the braeticable method of treatment,"storage,or disposal currentiv available to me ! which minimizes the present and future threat to human life and the environment:Or,it i am a small quantity generator,t have made a Good faitheffort to minlmize my'Waste generat)ori and select the waste management method that Is available to m;that I can afford. 'Amedcan Valley Waste Oil hereby advises the above Generator thatgenerators shipment of used oil may be transported to a facility that is required to comply with federal regulations applicable to management of used oil,but that is not required to comply with the More stringent requirements applicable to hazardous waste management:facili- ties.California-facilitles that handle or process used oil are required to meet those more stringent requirement,and some out-of-state facilities that process used oil also meet those,requirements,engineering cerfifications of tank integrity,and financial assurances for closure and accidental releases.It Is lawful to send used oil to out of state facilities that comply only with federal used oil management standards and riot these more stringent requirements. This notification is for information purposes only, By,both padres signing this invoice it will serve as an agreement that American Valley.Waste Oil will submit confirmation for(certain waste streams)to the generator that their waste has been transported to a licensed treatment or transfer facility. gs" GENERATflW e"' - 1 DRIt/ Fk`" f a BIGNATuRE , DATE � _ 04 nZ nIS100 A ` ! REOV.01 IMP—' SzAnit ITV ✓itJi \.!V L t 1 / ^' i %..f&- YIA i 1-tV11-1 1 ODK-'DIXON � �0 ASBURYENVIRCNMENTAL'O RIVERBANK OIL TRANSPER 'IC)YUMAYESLLC, - AMERICAN vutEYWASTE 011,ING 7300 CHEVRON WAY 192�1.MORGAN RD. 5soo CLAUS'RD� 6500 US HU�Y 9b � � 621 INDUSTRIAL DR STE M DIXON,'CA 95620 CERES,CA 195358 ' RIVERBANK CA95367 YUMA,AZ 88365 LIVINGSTON,CA 95334, 707-693-6008 209 541-1$25 209-863-8181 928-344-9898 209-667-8857 EPA#CAT080012602' EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 MPG(7/2016)