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AMERICAN VALLEY 173063 <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: EAST BAY CLARKLti T-CHfA JOB SITE; 1813 <br /> BAY FT Invoice Date: <br /> 4701 OAKPORT ST 1819 MOFFAT BLVD <br /> OAKLAND, CA 946014906 MANTECA CA 95336 <br /> G <br /> A <br /> Phone Customr P.O .eTerms <br /> 20946"987JENIF " <br /> WASTE <br /> L <br /> f PRODUCT SHIPPING DESCRIPTION MANIFEST QUANTITY PRICE ; AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 i <br /> NON - RCRA Waste Liquid Used Antifreeze 133 <br /> NON RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters c <br /> I <br /> i <br /> i <br /> i <br /> i <br /> TERMS: Invoices over 30 Daysare subject to a 1 .5% service charge. Customer ag , F _ rE, f,: regai fees it court action TOTAL <br /> becomes necessary to collectihis invoice. PC <br /> By signing I herby certflr that 1 have riot mixed any of the waste described above with arty other hazardous waste, the total halide content Is LESS than 1 ,000 ppm. and the i <br /> waste does not contain any PCBs, i have complied with the requirements of the applicable California used oil management regulation to determine this Istria, I agree to <br /> accept the additional charges for the disposal of this waste If the information I have provided about this waste 's Incorrect <br /> i Generator's Certification: By signing I oomry that tt tem 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 Ede and the onvironment: Or, if I Ire 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 all may be transported to a facllily that 15 required to comply with federal <br /> regulations applicable to management of used oil, but that Is riot required to comply with the more stringent requirements applicable to hazardous waste management faclil- <br /> ties. California tact ttles that handle or process used oil are required to meet those more stringent requirement, and some otn-of-state facllRies that process used dl also most <br /> those requirements, anglnsering certifications of tank Integrity, and financial assurances for closure and accidental releases, it is lawful to send used all to out of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <br /> I This notification is for information purposes oral*. <br /> By both parties signing this Invoice it will "No as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the generator that their <br /> waste has been t r:,=,"s ^ r ,tea licensed treatment or transfer facUty. <br /> I i <br /> DRI4 ' ii.' <br /> SIG RE DATE �r <br /> DATE: J <br /> - - / <br /> AL EfNCCT AMERICAN VALLEY WASTE <br /> O DK-DIXON O ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER fi S21INDUSTRIAL DR # M 3AL MATERIAL MGMT <br /> 7300 CHEVRON . AY 1920 MORGAN RD. 5300 CLAUS RD. / UViNGSTON,CA 95334 N. BROADWAY <br /> DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CA 95367 667-8857 ;KTON, CA 95206 <br /> 707-6936008 209.541 -1825 209-663-8161 CA3004 702577 <br /> l EPA# CAT080012602 EPA# CALDD0393680 EPA# CALOOD190816 CALOG0417316 <br /> MPC (72016) <br /> i <br /> i <br />