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AMERICAN VALLEY ` i <br />WASTE OIL, INC. Invoice Number:' <br />P.O. Box 340 •Delhi, CA 95315 <br />PH. 1-800-7324645 • FAX 209-668-3880 <br />EPA# CAR000272302 <br />BILL'TO: I P �I 1�'1a r i JOB SITE <br />€ a Invoice Date: <br />Q ;I IF IPS P t AH -D CEh4E *IT <br />i 8 230 PORT PC)a <br />8TC'Ckg t fs�i i 40A lr5203 <br />Phone <br />MPC <br />,Customer P.O. <br />Terms <br />EPA# � <br />2a° 46WIJI99;PA[` <br />30 t)pwx� <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 />Compliant Drained Used Metal Oil Filters <br />IL Co <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 />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, and the <br />waste does not contain any PCBs. l have complied with the requirements of the applicable California used oil management regulation to determine this is true. I 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 I 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: Or, 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 />GENERATOR/ <br />DRIVER AUTHORIZED - <br />SIGNATURE: DATE SIGNATURE: DATE: <br />, <br />DISPOSAL/ RECYCLING FACILITY` <br />O DK-DIXON OO ASBURYENVIRONMENTAL O RIVERBANK OILTRANSFER O YUMAYES LLC O AMERICAN VALLEY WASTE OIL, INC <br />7300 CHEVRON WAY 1920 MORGAN RD, 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM <br />DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CA 95367 YUMA, AZ 85365 LIVINGSTON, CA 95334 <br />707-693-6008 209-541-1825 209-863-8181 928-344-9828 209-667-8857 <br />EPA# CAT080012602 EPA# CAL000393680 EPA# CAL000190816 EPA# AZR000521146 EPA# CAL000443004 <br />(7/2016) <br />