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AMERICAN VALLEY 180861 WASTE OIL, INC. Invoice Number: P.O. Box 340 - Delhi, CA 95315 PH. 1-800-732-4645 - FAX 209-668-3880 EPA# CAR000272302 BILL TO: �,'I��f.ttil r,I,j .tfVrti.I UN,L1GI ILII,t TOB SITE: r,l r,Ct-.TC)tA F.VOTPIR UST. Invoice Date: ,767 F lie!A N 1,1T Cit GY E. MAIM CT©(;KT 0,`,J,r'A g0,2201 ?C (311.,L1:, L')T0CF,ra,I, CA 9J X11 Gini oil. Phone Customer P.O. Terms EPA# btovo PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT 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 Compliant Drained Used Metal Oil Filters OIL GOLLEC:II ON FEE: (_,C. TERMS—In voices over 30 bays are subject to a 1.5 rt servrce charge. Customer agrees to pay all legal leas ifcourtaction _ TO_TAL becomes necessary to collect this invoice. I , By signing I herby certify that I have not rn'xed any of the waste desLnbod above with any other hazardous waste.the total halide content is LESS than 1,000 ppm and the waste does not contain any PCBs I have complied with 1:e requirements of the applicable California used oil management regulation to determine this Is true I agree to accept the additional charges for the disposal of this waste if the informal on I have provided about this waste is incorrect. Generator's Certification By signing I cert.fy that f.am a targe quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generat- ed to the degree I have determined to be econornivaLy 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 iife and the environment Or,if I am a small quantity generator,I have made a Good faith effbn to min maze my waste generation and select the waste management method that is availab'e to me that I can afford American Valley Waste Oil hereby advises the above Generator that generators shjbmenl of used oil may be transported to a facility that is required to comply with federal regulations app!cable to management of used oil,but that is not required to comply with the mr:re stringent requirements applicable to hazardous waste management facili- ties California fac-11-ns that handle or process used oil are required to meet those more suingenl requirement,and some out-of-state fac.lities that process used o I also meet those requirements,engineering cedificai ons of tank rntegrAy,and financial assuranr.es for rIasure and accidental releases 11 is lawful to send used oil to out of state facilities that comply only wAr federal used oil management standards and not these mnro stringent requirements This notification is for infarmallon purposes only By both parties signing this invoice it will serve as an agreement that Amer_on Valley Waste O 1 will submit confirmation for(certain waste slreamsl to It,a generator that their waste has been transported to a licensed treatment or transfer fa-lily [ GENERATOR] DRIVER1 - I - AUTHORIZED SIGNATURE t \1� DATE I SIGNATURE DATE,,' D1 5POS AL l 9 ECYCZ]NQ EACIUTY O DK-DIXON Q ASBURY ENVIRONMENTAL O RIVERBANK OILTRANSFER O YUMAYES LLC O AMER--,'N VALLEY WASTE OIL,W. 7300 CHEVRON WAY 1920 MORGAN RD 5300 CLAUS RD 6500 US HWY 95 521 INDUSTRIAL DR STE M DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 a 707-693 6008 209541-1825 209863.8181 928-344 9828 209-667-8857 EPA#CAT080012602 EPA#CAL0003936BO EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004