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May 30 19 , 10 : 14a i p • 2 <br /> AMERICAN VALLEY 162038 <br /> WASTE OIL , INC . Invoice Number: <br /> PO . Box 340 • Delhi, CA 95315 <br /> PH . 1 -800-732-4645 • FAX 209-668-3880 <br /> EPA# CAR000272302 t <br /> BILL TO : KLUD7 OIL j0$ SITE: LINDEN PETERS FIRE DEPARTU4 to Date : <br /> P.O. BOX 166 17725 E , NWY26 <br /> LODI, CA 95241 LINDEN, CA 95236 <br /> Phone Customer P.O, Terms EPA# <br /> 209-887-371p JAMES Net30 Days C, LD000944 6 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 G ► �r.f7 Ul i J" o S . <br /> NON - RCRA Waste Liquid Used Antifreeze 133 <br /> r <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> OIL COLLECTION FEE <br /> `# ti4 <br /> Sales Tax <br /> TERbeta 3: Invoices over co Da �8 are subject to a 1 .5°5 service charge. Customer agrees to pay all legal tees if court action TOTAL <br /> gecarnes necetisary to Coile�IfTls fnvotce. V`"� • <br /> By s)gning I herby csrilfy that i have not mixed any of the waste describOd above with ary other hazardous waste, the total halide content is LESS than 1 ,000 ppm, and the <br /> waste does not contain any PCBs. I have compiiadvAlh fie recuirements of the applicable Colifomta used oil management regulation to datermins this Is we. I agree to <br /> accept the additional charges for the disposal or this waste it the information 1 have provided about tuts waste Is Lnccrreet. <br /> Ger4Mor's Certification: By signing 1 certify that it i am a large quantity generator. I certify that I have a program to place to reduce the volume and toxicity of wrests general. <br /> ad to the degree i have detemlined to be economically offordabis and that I have soleeted the practicable method of treatrr t, storage, or disposal currently available to me <br /> which minimizes tie present and ruture threat to human life and the environment: Or, if I am a small quantity generator, I have made a Good faith effort to minimire my waste <br /> generation and select the waste management method that Is available to me that 1 can afford. <br /> American Valley Waste 08 hereby advises the above Generator that generators shipment of used oil may be transported to a facllhy that is required to comphy with federal <br /> fegulatlons eppileablato Management of used oil, but that is not requirod to comply with the more stringent requirements applicable to hazardous waste management facul- <br /> ties. Califomla facilities that handle or process used oil are required to meat tiv>se more stringent requirement, andsone outaof-state faoilhles that process deed all also meet <br /> those requ4emants, engineering certifications of tank Integrity, and financial assurances for closure and nooldental miames. it 4 lawful losend used oil to out or state faclfities <br /> that comply only with federal used oil management standards and not these more sMagent requiremerts. <br /> This nolrficaticxl is rorinformation purposes only. <br /> By both parties signing this Invoice 4 will serve as an agreement that American Vi ley Waste Olt %*All submit contirmatlon for (certain waste streams) to the generator that then <br /> waste has been transported to a keened treatment or transrertacisty. <br /> r GENER4TOft! <br /> SIGINNATURl:: kat�.�+� du `C:�Z � DATE ' ^q � �, 8iQNANRE: y Oick <br /> DISPOSAL ECYC I G. FACILITY <br /> Q DK-DIXON C, ASBURY ENVIRONMENTAL O RIVERBANK OILTRANSFER O CFR Q GLOBALMATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 6300 CLAUS RD, 2035 Es 16TH ST, W40 N . BROADWAY <br /> D)XON, CA 86620 CERES, CA 95356 RIVERBANK, CA 96387 LA, CA 80021 STOCKTON, CA 95205 <br /> 707.693 .6008 1 209-541 -1826 209-863-81st 213.748.0237 818.770.2577 <br /> EPA# CAT080012602 EPA* CAL000393680 EPA#rCALOOoi80816 EPA# CAL000210577 EPA# CAL000417316 <br /> MPC (72816) <br />