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N"Wast1111111111low AMERICAN VALLEY pg ! on� 62729 WASTE OIL , INC . W Invoice Number: P. O. Box 340 • Delhi , CA 95315 PH . 1 -800-732-4645 • FAX 209- 6 &3880 t710'1710-AKPORT -FPGA#� CAR000272 2 .? MUM Y CLARKLIFT-CHM T TE: EAST 64Y Ci ARKLiFT Invoice A4 1815 MOFFiAT BLVD D, CA 946014908 b_ . MANTECA, CA 95338 1 _ _ Phone ( Customer P.O. v \ _ . EPA# 209 485 8887 JENIFER C.O.D. CALDD0394327 PRODUCT SHIPPING DESCRIPTION -� WasTE MANIFEST ANTfTY PRICE FA MOUNT MOUNT 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 j Drained Used Oil Filters ( j OIL COLLECTION FEE ("�� t t 1 _- j _ _ I TERMS: Invoices over 30 Days are subject to a 146% service charge Custorner agrees to pay all legal fees If court action TOTAL becomes necessary to collect this invoice. � + -- By stoning I herby Cerny nest I have not mixed any of the waste described above with any olor harardoua waste, the total halde content is LESS than 1 ,000 ppm, and the waste does tot contain any PC8s. I have compiled with the requlernents of the appficab!e California used of management regulation to determine this is Inns. I agree to I accept the additional charges for the disposal of thin waste g the information i have provided about this waste Is Incorrect, G156arator's Certification: By signing I certify that N I am a large quantity generator, i certify that 1 have a program In pisco to reduce the volume and toxicity of waste gen orat- 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 fila and the environment• Or, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the waste management rnedod 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 required to comply with federal 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- ties, California facilities that handle or process used oil are required to meet those mote stringent requirement, and some oul-of-stato facilities that process used oil also most those requirements, engineering certlkations of tank integrity, and financial assurances for closure and accidental rereaem it is lawful to send used oil to out of aisle facilities that comply only with federal used oil managemant standards and not these more stringent requirements, This notification to for Information purposes only, By both parties signing this invoice It will servo as an agreement that American Valley Waste Oil will submit confirmation for foertain waste streams) to the generator that their waste has been transported to a licensed treatment or transfer facility. I GENERA DRIVER E — SIGNATURE: MBIZED SIGNATURE: ?�-�""` "✓ OATE: ;.'r� y'�fof` SIGNATURE: �""'` DATE: �7 ,r - DISPOSAL / RECYCLING FACILITY O DK-DIXON ASBURYENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT 7300 CHEVRON WAY 1920 MORGAN RD, 5300 CLAUS RD. 2035 E. 15TH ST, 1640 N. BROADWAY DIXON, CA 96620 CERES, CA 95358 RIVERBANK, CA95367 LA, CA DW21 STOCKTON, CA 95205 707.693-15008 209641 -1B26 209.863-8181 213446-0237 818-770.2577 EPA# CAT080012602 EPA0 CAL000393680 EPA# CAL0o0190816 EPA# CAL000270577 EPA# CAL000417316 —J MPC (78616)