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AMERICAN VALLEY 10 b i tli u <br /> WASTE ❑1L, 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 /> &a Zy -/Z <br /> ,LTO; JOB SITE: 1 � ��` Invoice Date: <br /> ane Customer P.O. Terms EPA# <br /> �Cr - � <br /> ODUCT SHIPPING DESCRIPTION WASTE MANIFEST m-ray PRICE AMOUNT <br /> CODE <br /> -N-RCRA Waste Liquid Used OiVMixed Oils 221 <br /> 26 <br /> N-RCRA Waste Liquid Used Antifreeze 133 j CO <br /> N-R CRA Waste Liquid!Used Oily Water 223 <br /> fined Used Oil Filters <br /> AS: invoices over 30 Das are subject to a 1.5%service charge. Customer agrees to Pay all legal fees if court action TOTAL <br /> mes necessary to collect this Invoice. <br /> ;lgning 1 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 4,000 ppm,and the <br /> its does not contain any PCBs.k have complied with the regtimments of the applkcable California used oil management regulation to determine this is true.I agree to <br /> opt the additional charges for the disposal of this waste if thq intonation I have provided abatrt this waste Is Irwarreet. <br /> feraloes Certifioatkont By slgning l cartify that if I am a large quantity generator,I codify that k have a program in place to reduce the vo&jme and toxicity of waste ganatat- <br /> o the degree 1 have determined to be economically affordable and that 1 have selected the practicable method of treatmark storage,of disposal currently available to me .l <br /> :h minlmkzas 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 /> eration and select the waste management method that is available to me that l can afford. ar <br /> rnccan 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 /> dations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management fackil- <br /> Cardornia tacilgles that handle or process used all are required to meet those more stringent req ulrement,end some out-of-state faclltllas that process used oil also meet <br /> is requirements.engineering certifications of tank integrity.and financial assurances for closure and ncc}dsntal releases•it is lawful to sand used all to out of state facilities <br /> comply only with federal used oil management standards and not these more stdngent requirements. <br /> notification Is for information purposes only. <br /> mth partlas signing this Invoice it will serve as an agreement that American Valley Waste OA will submit confirmation for(certain waste stream)to the generator that their <br /> to has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> ER AUTFiORiiEO <br /> ATl1RE: �, DA7E SIGNATURE: z- LS GATE <br /> Year <br /> POSAL 1 RECYCLING E CILiTY_ <br /> K-DIXON ❑ASBURY ENVIRONMENTAL ❑ RIVERBANK OIL TRANSFER ❑ CFR ❑GLOBAL MATERIAL MGMT <br /> •70 CHEVRON WAY 1920 MORGAN RD. 5340 CLAUS RD. 2035 E.15TH ST. 1640 N.BROADWAY <br /> :ON,GA 9560 CERES,CA 95358 RIVERBANK. CA96367 LA,CA 90021 STOCKTON,CA 95205 <br /> V n-69MOOB 209-541-1825 209-863.8181 213-746-0237 819-770-2577 <br /> PA#CAT080012602 EPA#CAL000393680 EPA#CAL000990816 EPA#CAL000270577 EPA#CALOD0417316 ear <br /> MPC(7=16) <br /> ATOR <br />