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ui Mfi W& � ��'` p� To 0 AMERICAN VALLEY 159744 <br /> vo 9 7 4 <br /> WASTE SIL, INC . Invoice Number: <br /> 'b Mow P.O. Box 340 • Delhi , CA 95315 <br /> PH . 1 -800-7324645 • FAX 209-668-3880 <br /> EPA# CAR000272302 <br /> EAST BAY CLARKLIFT-CHM EAST BAY CLARKLIFT ! , <br /> 4701 OAKPORT ST )OS SITE: 1819 MOFFAT BLVD Invoice Date: <br /> BILL TO: OAKLAND, CA 946014906 MANTECA, CA 95336 <br /> Sates Rep <br /> ------ � l t L _.., _ .. ._ _ ---- C.O:i _ _ EPAfk�4L000394327 <br /> Phone`" ( Gust P 0. , Terms <br /> "S C� WASTE I MANIFEST IOUANTIiY PRICE AMOUNT <br /> PRODUCT SHIPPING DESCRIPTION _ <br /> CODE <br /> NON-RCRA Waste Liquid Used OillMixed Oils 221 <br /> i <br /> NON -RCRA Waste Liquid Used Antifreeze 133 <br /> NOWRCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> i 1 TlCSi FE f j <br /> r <br /> { I <br /> TERMS: Invoices over 30 Days are subjactt 16 a 1 .5% service charge. Customer agrees to pay all legal fees it court action TOTAL <br /> becomes necessary to collect this Invoice. <br /> By signing I herby carlify that I have not mixed arty of the waste described above with any o0wr hazardous waste, Ito total halida content 6 LESS than 1 ,000 p1xn, and the <br /> waste does not contain arry PCBs. I have compiled with the requirements of the applicable California used oil management regulation to datenmine this is true. I agroo to <br /> accept the additional charges for the disposal of this waste lithe information I have provided about this waste Is Iraorreot. <br /> Generator's Certification: By signing 1 certify that If I am a large quantity generator, l certify that I have a program In place to reduce the volume and toxicity of waste 900arat- <br /> ed to the degree 1 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 mktimizes ft present and future threat to human Ilio and the emIronment• Or, N 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 011 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 appucabia to management of used oil, but that is not required to comply with the mora stringent req i anrerds aWleable to hazardous waste management facill, <br /> Use. Calromia facilities that handle or process used oil are required to meet Ouse more stringent requirement, and some out-of-stats facass that process used oll also meet <br /> those requirements, engineering cedificallons of tank integrity, and financial assurances for closure and accidental raises", it is lawful to send used oil to out of state facifNes <br /> that comply only with federal used all management standards and not these more stringent requlrsments. <br /> This ratification is for information purposes ordy. <br /> By both parties signing this invoice It will serve as an agreement that American Valley Waste Oil w81 sttixn t confirmation for (certain waste streams) to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR rn <br /> I AUTHORIZED . n ) <br /> DRIVER '} ) ` J DATE: <br /> tT <br /> SIGNATURE. }, <br /> ''�. .,��� aSK3NATURE .X_� -.m._ {� <br /> pISPOSAL 1 RECYCLING FACILITY oe <br /> O DKftDIXON O ASBURY ENVIRONMENTAL gRIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 6300 CLAUS RD, 2035 E. 15TH ST. 1640 N. BROADWAY <br /> DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CA 95367 LA, CA 90021 STfJCKTON, CA 95205 <br /> 707-693-6008 209.641 -1825 209.863-8181 213-745.0237 818470-25T7 <br /> EPA# CATOBOD12602 EPA# CAL000393680 EPA# CAL00019OB16 EPA# CALOOD270577 EPA# CAL000417316 <br /> — _— — <br /> MPO 17120181 <br /> i <br /> i <br />