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AMERICAN ,VALL <br /> ^ ' V 142790 <br /> ft' SZS OIL , INC . Invoice Number: <br /> P. O. Box 340 • Delhi , CA 95315 MAR 02 2016 <br /> PH . 1 - 800 -7324645 • FAX 209-6687 <br /> �WH N NT AL <br /> EPA# CAL000827878 V / IleHE�.jY{-! r11*4�Ai"l'T�rfFl\!T <br /> J .M EQUIPMENT J .M EQUIPMENT <br /> BILL TO : 321 SPRECKELSAVE JOB SITE : . 231 sFRJ CKr= LSAVr qnvoice Date : <br /> MANTECA, CA 95336 MANTECA, CA 95336 <br /> ` 30D OIL 60D SUM <br /> Sales Rep <br /> Phone209-275-6265 SCOTT Customer P. O. TermsNet 30 Days EPA# CALOW350320 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNTA <br /> CODE <br /> NO-NmRCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON- RCRA Waste Liquid Used Antifreeze 133 <br /> NON - RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters . <br /> HAZARDOUS WASTE PICK UP- ABSORBENTS AND OIL -�- <br /> } 05 GAL OrrOP U , N CERT� TEEL RECON o0 <br /> Sales Twx <br /> � .. <br /> TERMS : Invoices over 30 Days are subject to a 1 . 5% service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By sligning I herby certify that I have not mixed any of the waste described above with any other hazardous waste, the total halide content is LESS than 1,00b ppm, <br /> and the waste does not contain any PCBs . I have complied with the requirements of the applicable California used oil management regulation to determine this is <br /> true.II agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect. <br /> Generator's Certification : By signing I certify that if I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste <br /> generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment, storage, or disposal currently <br /> available to me which minimizes the present and future threat to human life and the environment: Or, if I am a small quantity generator, I have made a good faith <br /> effort to minimize my waste generation and select the waste management method that is available to me that I can afford . <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> DIVER AUTHORIZED <br /> SIR0/ <br /> GNATU DATE: la , SIGNATURE DATE: <br /> DISPOSAL / RECYCLING FACILITY <br /> O DK-DIXON O CFR O UNITED ENTERPRISES CORP <br /> 7300 CHEVRON WAY 2035 E . 15TH ST. 11190 PENROSE ST. <br /> DIXON , CA 95620 LA, CA 90021 SUN VALLEY, CA 91352 <br /> 707-693-6008 213-746-0237 818-787-2649 <br /> EPA # CAT080012602 EPA# CAL000270577 EPA# CAL000379059 <br /> MPC (6/ 1 ) <br /> af 1qSP n > Srcrr <br />