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.-HECEIVED <br />JAN 3 0 2015 <br />ENVIRONMENTAL.- <br />r4r7l!"rU T717"01MIr'47NI-r <br />El <br />AMERICAN VALLEY <br />WASTE OIL, INC. <br />P. O. Box 340 * Delhi, CA 95315 <br />PH. 1-800-732-4645 * FAX 209-668-3880 <br />EPA# CAL000827878 <br />BILL TO: . ;ISE?0i JOB SITE. <br />Sa i e -1 �: $� ,, -- P <br />1 4 <br />Invoice Number: <br />Invoice Date: <br />Phone <br />Customer P.O. <br />Terms <br />EPA# <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Drained Used Oil Filters <br />8EL- <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 />TOTAL <br />becomes necessary to collect this invoice. <br />I <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, <br />and the waste does not contain any PCBs. I have complied with the requirements of the applicable California used oil management regulation to determine this is <br />true. I agree to 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 <br />generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment, storage,.or disposal currently <br />available to me which minimizes 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 <br />effort to minimize my waste generation and select the waste management method that is available to me that I can afford. <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 <br />that their waste has been transported to a licensed treatment or transfer facility. <br />GENERATOR( <br />DRIVER AUTHORIZED <br />SIGNATURE:..- DATEf.-' SIGNATURE: DATE: <br />DISPOSAL I RECYCLING FACILITY <br />0 DK-DIXON 0 CFR 0 UNITED ENTERPRISES CORP <br />7300 CHEVRON WAY 2035 E. 15TH ST, I 1190 PENROSE ST. <br />DIXON, CA 95620 LA, CA 90021 SUN VALLEY, CA 91352 <br />707-693-6008 213-746-0237 818-787-2649 <br />EPA# CAT080012602 EPA# CAL000270577 EPA# CAL000379059 <br />MPC J612013) <br />6-d ZEST -928-602 jnH UlAaN e1g:S0 91 06 uer <br />