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AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340 - Delhi, CA 95315 <br /> PH. 1-800-732-4645 - FAX 209-668-3880 <br /> EPA# CAR000272302 <br /> ASS00l TIV�Gr()R <br /> BILL TO: '1323 Of. CHARTER VVY S, rDC,iATL-1 71RAC-i'Cjjl� <br /> "S JOB SITE: A".__ � <br /> TOICKT01%).C-111 CY_;"�n% 6 WAN.- Invoice Date: <br /> Silas F e P AfflaricariVafley <br /> ROCKY Customer P.O. Term EPA# Dc <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 /> V— <br /> 'U N PAI L F(,)R N1 E7,Al.SHA u!N i <br /> Y <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court—action <br /> becomes necessary to collect this.invoice. TOTAL <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,and the <br /> waste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree to <br /> 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 it I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generat- <br /> ed to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently available to me <br /> which minimizes the present and future threat to human life and the environment:Or.if I am a smai I quantity generator,I have made a Good faith effort to minimize my waste <br /> generation and select the waste management method that is available to me that I can afford. <br /> American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility that is required to comply with federal <br /> 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- <br /> ties.California facilities 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 <br /> those requirements,engineering certifications of tank integrity,and financial assurances for closure and accidental releases.It is lawful to send used oil to out of state facilities <br /> that comply only with federal used oil management standards and not there more stringent requirements. <br /> This notification is for information purposes only. <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 that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> DRIVER GENERATOR/ <br /> SIGNATURE: AUTHORIZED <br /> DATE: SIGNATURE: DATE: <br /> DISPOSAL / RECYCLING FACILITY <br /> 0 DK-DIXON 0 ASBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 CFR 0 GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD, 2035 E. 15TH ST 1640 N.BROADWAY <br /> DIXON,CA 95620 CERES, CA 95358 RIVERBANK, CA95367 LA, CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 209-541-1825 209-863-8181 213-746-0237 818-770-2577 <br /> El CAT080012602 EPA#CAL000393680 i CAL0001 90816 1 CAL000270577 Ei CAL000417316 <br /> J. . —&Apr <br />