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i AMERICAN VALLEY 173062 WASTE OIL , INC . . Invoice Number. P,Q , Box 340 Delhi, CA 95315 PH . 1 -800-7324645 • FAX 209-668-_3880 EPA# CAR000272302 BILI. TO: EAS 01 p�R�IFT-CHM - SITE: EAST BAY CLARKLIFT Invoice Date: 1813 MOFFAT BLVD OAKLAND, CA 946014906 ' MANTECA, CA 95336 Phone Custom P.O. _ Ter s EPA# � P 209.46&8987JENIF R C.O.O. CALOOD394327 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTfTY PRICE AMOUNT CODE f 3 NON RCRA Waste Liquid Used Oil/Mixed Oils 221 1 _ I n --- - __ _ - NON-RCRA Waste Liquid Used Antifreeze 133 ; NON-RCRA Waste Liquid Used Oily Water 223 t i Drained Used Oil Filters i ! I i k i , TERMS: Invoices over 30 Days are subject to a 1 .5% service charge. Customer a—�Y��>; q' h Tegal fees ff couA action ( TOTAL C7t;3 becomes necessary to collect this invoice. By signing I harby certlfy that I have not mixed any of the waste described above with any other hazardous waste, the total halide content is LESS than t ,ODO ppm, and the waste does not contain any Pces. 1 have complied with tho requ-irenxvits of " applicable CaiHomia used oil management regulation to determine Utas is true, I agree to accept the additional charges for the disposal of this wasto H the Information I have provided about this waste Is Incorrect, I Genoralor's Certification: By signing I certify that H I am a large quantity generator, 1 certify that I have a program in place to reduce tits volume and toxicity of weals 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 file and the environment: Or, H I srrr a small quantity generator, I have made a Good Wh effort 10 minimize my waste _ generation and select the waste management method that is available to me that 1 can afford. American Valley Waste 08 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 all, but that is not required to comply with the more stringent requirements applicable to hazardous waste management Win& ties. Cal fomle facilities that handle or process usod oil are required to meet those more stringent requirement, and some out-of-stale facilities that process used oil also meat those requirements, engineering certifications of tank integrity, and financial assurances for closure and accidental releases. It is lawful to send used oll to out of state factl0les that comply only with federal used all management standards and not these more shirgent requirements. '.. This notification is for information purposes only. 6 By both parties signing this invoice it WR 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, r GENERATOR/ DRIVER _ AUTHORIZED r SIGNATURE j DATE f ti SIGNATURE DISPOSAL I RECYCIM FACILITY O DK-DIXON e66URY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O GFR Q GLOBAL MATERIAL MGMT 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E. 15TH ST 1640 N. BROADWAY DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CA 95367 LA, CA 90021 STOCKTON, CA 95205 707-693.6008 209-541 -1825 209-863-8181 213.746-0237 818-770.2677 EPA# CAT080012602 EPA# CAL000393680 EPA# CAL000190816 EPA# CALOD0270577 EPA# CAL000417316 rtvc (7rete)