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AMERICAN VALLEY 'l , 052 WASTE ®IL, INC. Invoice Number: P.O. Box 340 • Delhi, CA 95316 PH. 1-800-732-4645 • FAX 209-668-3880 EPA# CAR000272302 BILL TO- JOB SITE: Invoice Date Phone Customer P.O. Terms EPA# PRODUCT SHIPPING DESCRIPTION WASTE I MANIFEST QUANTITY PRICE AMOUNT CODE l 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 Oil Filters 3 i I 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 E have d any of the waste described above with any other hazardous waste,the tota3 halide content is LESS than 1,000 ppm,and the waste does not contain any PG3s.+ _ = : r`ied with the requirements of the applicable California used oil management regulation to dete-nine this is true.I agree to accept the additional charges fort#, :: ante If the information I have provided about this waste is incorrect. Generator's CertificaVcn:By signing;cen . : _. _-_'arge quantity generator,€certify that I have a program in place to reduce the veiame and toxicity of waste ge,era-- ed to the degree I have determined to be _ _ ._ - =. . _able and that I have selected the practicable method of treatment,storage,or disposal currently availabie to.<. which minimizes the present and future hres; _ _. e environment:Or,if 1 am a small quantity generator,I have made a Good faith effort to minimize my wast generation and select the waste management- = = . .. :.= c me that I can afford. American Valley Waste Oil hereby advises the above _r= : __ : _=ors shipment of used oil may be transported to a facility that is required to comply with fedora: rngulatlons applicable to management of used oil,but t^s: = :. __._ -: .comply with the more stringent requirements applicable to hazardous waste management _- ;es.Calffornia facilities that handle or process used oil are,e - - 'e= -_=more stringent requirement,and some out-of-state faciittes that process used oil aao -; e3 irements,engineering certifications or tank integrif - : : _ rances for closure and accidental releases.It is lawlu',to send used oil to out of state _= e')fy with federal used oil management standards =_ c=e stringent requirements. information purposes only. E,-. ::_ _ -_,,'s ins:nice it will serve as an agreement that Amenca--WjFay Waste Oil will submit confirmation for(certain waste streams)to the generator t9im fir. `:icersed treatment or transfer facility. - GENERATOR/ D = AUTHOWED c_ DATE SIGNATURE: vATE: F ©ISPOSALf KCYCLING FACILITY %3 ©K-OIXON O ASSURY ENVIRONMENTAL Q IIIVERSANK OIL TRANSFER O YUMA YES LLC Q A -= -- 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 t75 HWY 95 ti- ----- ---- - DIXON.CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 - -_- --_ X33-gong 209-541-1825 209-863-81.81 928-344-9828 -- -- - _---,_-- =af2602 EPA#CAL000393680 EPA#GAL0D0190816 EPA9AZR600521146 = - - ------ --