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AMERICAN VALLEY <br /> 169539 <br /> assInvoice Number: <br /> WASTE OIL, INC. <br /> P.O. Boz 340' • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209=668"3880 <br /> EPA# CAR000272302 <br /> AMERICAN PAVEMENT SYSTEMS INC AMERICAN PAVEMENT SYSTEMS IN(rft'ld <br /> 101211TH ST SUITE 1000 JOB • 17333COMOONEXRD Invoice Date: <br /> $TLLTO: 'MODESTO, CA 95354 MANTECA CA 96338 <br /> Sides Rep: <br /> Phone - Customer P.O. Terms C.O.D. EPA# CAL000420454 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUAN1T PRICE AMOUNT <br /> CODE <br /> ' NON•RCRAWaste LlgUid'Use`d OillMlXed Oils' ' - " 221 "' " ' '� p ' 48. <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON,RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Fitters <br /> Oil 1 � <br /> j SAUES TAX - , <br /> 'TERMS: Invelces+over SODA <br /> erosubjuclto a l.5%.service charge. Customer agrees td pay'ell legal fees It court action TOTAL <br /> becomes necessary to.Collet this invdca, _ 7 <br /> By slgirdrig l Aeby carry that I have notindited my ofth i d Hiadabo With my otherll ' d sta. the total haidecontenl is LESSMem TOMO NernaMihe <br /> waste doe tnty PCs& I harbe complued.w1hpia regWrema is of the enclosure Coliondausted 09 menngamentragulallon to determine this is we. l agree.to <br /> ccelit the additional chorgae rot tie disposal of this waste if the Interaction) have provided abpbt this waste Is Incorrect. <br /> GcoWaacesCaNgcar By signing I minity there l the glog W Nity generator Icouty that l haw apdgmmte place lateduce the mining out h0delty fw , . l general' <br /> ad to the degree I boo determined to be economically afforclableandH l I have s e1 cted the pagUoabie method of treatment stag or disposed cudeaHY avaliable tome <br /> wNch minanlzeethe present and future threat to human#to and Me emumbeent. or, if ama wall quantity genemto5l have made a Gootl faith effort to terbium mywaste <br /> g6nmaPon and"tact the waste management Mal hod that is needs btetome lhati can affmd. <br /> American uWay Waste ORhereby tulvises the above Generator Mat genamiom siifpneN of used ON myb transported to a facility Chet is requited to comply WIM federal <br /> regulations oplelicoble to N gmonl of usedol; but that is not required to.comply with the mstringent,-requirements applicable To hazardous waste management h all, <br /> Hes. CatlfaNa facilklea that hdl pmoe s Used oil we required to me at those re stringcut requirement, and Boma cul of-etele.faciYgacthat precious used filleted mot <br /> throw roqu(mvnenls. engineering Hifi N na of twkinlegdy, and 6manda awarances for closure and amblental mission, II is lawful to mid used all to out of state facilities <br /> tient comply only Wlh federal used al management Miniatures end not these more ablngantragWemem0. <br /> This muttiagonis(or information purposes only. ' <br /> By been parties seging this invoice it will cove as ori idneereard Mat American Valley Waste Oil will submit conwidan for (cartel n waste streams) to the generator Nal their <br /> wasta has been transported to a retained ten1ow or Goal racauY, <br /> GENERATOR <br /> DRIVER AUTHORIZED' <br /> SIGNATURE: �� DATE: •/ (iSIGNATUR DgTE1 ,P <br /> DISPOSAL LB Ca FACILITY <br /> O DK-DIXON ASBURY ENVIRONMENTAL O RIVERBANK OILTRANSFER O CFR O GLOeALMATERIALMGMT <br /> 7300 CHEVRON WAY 1920 MORGAN,RD. 6300 CLAUS RDS 2035 E. 16TH ST, 1640 N. BROADWAY <br /> DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CASS367 LA, CA 90021 STOCKTON, CA 95205 <br /> 707-693.8008 ' 269,541-1826. 269&9039187 213.746-0237 61B-770.2577 <br /> EPA# CATOBOD12602 EPA# CAL000393680 EPA# CALO0o190816 EPA# CALOOD270577 EPA# CALOOD417316 <br />