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"A AMERICAN VALLEY 4 <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# CAS 000416714 <br /> BILL TO: JOB SITE: A6 6�j(A A I F-L) I IRA C;1 OR Invoice Date: <br /> ASSN.CIATED"FRACTOR "2123 VV.CHAR F EP% WAY <br /> 1323 W. CHART ER VVY A:aW30NAU] &Fl`,�Il <br /> ST(I)CKTON, C,A 9.")1� )6 6]C'C M Clt�, CA 9b_'Ob <br /> Phone Customer P.O. Terms s�ll,ERAW r4iieiican Valley <br /> 2(X�­4 6 F>-,50 103 R Q(X Y 1vei3o Lau 6 i,AG98,3bU69:30 <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 233 <br /> Drained Used Oil Filters <br /> 4. <br /> r <br /> b6QAL WI'Gil l 6Liiii 6!=h4ki_ <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 p&%an- the <br /> waste does not contain any PCss.I have complied with the requirements of the applicabte 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 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- <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 minirl 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 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 these 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 /> GENERATOR/ <br /> AUTHORIZED If <br /> DRIVER <br /> 1_01 ,e �-, .. .,­ ,/, r ;' - [ :- :-- DATE: <br /> ` ­ .. . - ,;_ '�,- �%GNAIL[RE: <br /> SIGWURE: DATE: r I .� <br /> 717-y <br /> DIS-PQSAL I RE-CYCLING 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, CA 95367 LA,CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 707-693-6008 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL0001 90816 EPA#CAL000270577 EPA#CAL000417316 <br />