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AMERICAN GALLEY <br /> i5lt" v8 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Bax 340 - Delhi, CA 95315 <br /> PH. 1-800-732-4645 - FAX 209-668-3880 <br /> EPA# CAR000272302 <br /> BILL TO: N&S TRACTOR JCB SITE: N&S TRACTOR Invoice Date: <br /> P.O BOX 910 1340 W.CHARTER WAY <br /> MERGED,CA 953 31 STOCKI'ON,GA 95206 <br /> 1M OIL <br /> Phone Customer P.O. �7 Terms baes e EPA# <br /> 1�9�944-55U£�BR QIV � 1�� Net 30 Dmsf.a fln <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221L,Y� <br /> NON-RC RA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> 1AU <br /> V <br /> t <br /> 5aies Tax <br /> TERMS: Invoices over 30 Days are subject to a 11.50%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing 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 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.F 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 1 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 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:C,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 /> GENERATORI <br /> DRIVER AUTHORIZED �7 -f� <br /> SIGNATURE: DATE:?,, y iGNATURE: r�"� DATES-'��-'� <br /> "'1SPCSAL/ RECYCLING FACILITY <br /> J DK-DIXON Q ASBURY ENVIRONMENTAL Q RIVERBANK OILTRANSFER Q CFR i ..,Q'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, h 60021 STOCKTON,CA 95205 <br /> 707-693-6008 209-541-1825 209-863-8181 213'7446-0237 818-770-2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL00D190816 EPAl AL000270577 EPA#CAL000417316 <br /> MPC(7/2016) <br />