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AMERICAN VALLEY �p� 11�fQ►STE 011-3 INC. 177213 Invoice Number: P.O. Box 340 . Delhi, CA 95315 PH. 1-800-732-4645 ® FAX 209-668-3880 EPA# CAR000272302 / SILL Too il° JOE SITE: r' - _ ' 1'R�t' SPOR`I`ATION Invoice Dater' 5101 W: I ITIS ST OVNEY TR0,lSPORTATION TR tom`,CA 9G 5161 W. 11TH ST TRA CY,CA 953(A Phone Customer RO. Terms EPA# 2t9-X32-6"f81 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE"' : AMOUNT CODE 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 TERMS: Invoices over 30 Days are subject to a 1.5%service charge. ustomr Ceagrees to pay all legal fees if court action becomes necessary to collect this invoice. TOTAL By signing I herby certify that I have not mixed any of the waste described above with any other hazard accept the additional charges for the disposal of this waste if the information I have provided about thious waste,the total halide content is LESS than 1,000a A waste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regutatioh to determine this is true.I agree to s wastes incorrect, ppm,and fhe Generator's Certffication: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 tpxicity o€waste generat- 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 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 fafth effort to minimize my waste generation and select the waste management method that is available to me that I can afford. American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility that is requto y with fed regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management fa ired compleral cifl- ties.California facilities chat handle or process used ell are required to meet those more stringent requirement,and some out-of-state facilities that process used oil alsomeet 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 fa that comply only with federal used oil management standards and not these more stringent requirements. cilities This notification is for information purposes only, 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 waste has been transported.to a licensed treatment or transfer facility. DRIVER GENERATOR/ SIGNATURE: r AUTHORIZED DATE: SIGNATIJR>=: DATE: DISPOSAL/ RECYCLING FACILITY O DK-DIXON ASBURY ENVIRONMENTAL O RIVERBANK OILTRANSFER Q YUMA YES LLC ( AMER?CAN VALL€Y WASTE OIL,INC7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 0500 us Hwy 95 ` -5 21 DR DIXON, CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 5365 LIVINGSTON,IAL CA 95334E M 707-693-6008 209-541-1825 209-863-8181 928-344-9828 209-667-8857 EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 MPC(712016)