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V VALLEY 176329 <br /> AMERICAN Invoice Number: <br /> WASTE ()IL, INC. <br /> P.O. Box 340 - Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA#CAR000272302 <br /> BILL TO: FI11•aL.I 11Ut u JOB SITE: - 1,11111"H101-0 Invoice Date: <br /> 41OA N JAC#� 'I ONE RCS 47 1-09 hl JACK TOFF—PD <br /> GTOCI�TON,CA OG210 $r()CRTON.If:A 95240 <br /> FAICHICustomer P.O. Terms EPA# <br /> FPhoe �V .'� .r q MANIFEST QUANTITY PRICE AMOUNT <br /> DUCT SHIPPING DESCRIPTION WASTE <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 -J(_ 1 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> t.1IL GULLEC I I ON f-EL <br /> •Pa <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees Io pay ail legal fees if court action TOTAL, <br /> becomes necessary to collect this Invoice, <br /> By signing I herby certify that I have nut mined any of the waste deacnbed above with any other hazardous waste,the total hWe contefTt Is LESS than 1,000 ppm,and the <br /> waste does not contain any PCBs.I have complldd with the requirements of the applicable California used oil management regulation to determine this is true.I agree to <br /> accept Ree additional charges for the disposal of this waste it tits ielarrnalion I have provided about thls waste is Incorrect <br /> Generator's Certification:By signing I certify that a I am k large quantity ganeratar.I certify that I have a proomm M place 10 reduce the volume and toxicity of waste generat- <br /> ed to the degree I have determined to be economically affordabts end 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 fife and the environment_Or.if I am n srnmll quantity goneratof,I have made a flood faith effort to minimlze my waste <br /> genefai'ron and select lho waste management method that Is avaltamo to me that I can afford. <br /> American valley waste Oil hereby advises the above Comelof that generalon shipment of used oil may be transported to a facillty that is required to comply with federal <br /> regulallgns applicable to management of used od,but that is not requled to comply with the more stringent requiremeate eptago le to hnzardous waste managamenl facto- rh` <br /> Iles,ationCalifapplicable <br /> niafacilitieslibt that handle or process used oil are rcqui ed to meet prose mare atringant mquinimAnt.and some out-of-state Wlh!ie9 that process used olt also meet±' <br /> those requirements,angtneefing cerlificelions of tank Integrtty,and financial aswarim for closure and accklental ie•eases.It Is lawful to send used oil 10 out of stale facRitles <br /> that comply only with federal used oil management standevds and not Iheea mare sutrgent requhemants. <br /> This notillcaiiot Is for inlormation purposes only. <br /> Sy both parties signing this invoice it will swve as an agreement that Anmrican Valley Waste 011 wilt submit confirmation for(oedain waste atrrams)to the generator that their <br /> waste has been transported to a licensed treatment or trafgler facrvty. <br /> GENERATORI <br /> DRIVER1r AUTHORIZED <br /> SIGNATURE' r 1 I DATE i SIGNATURE; r� ' <br /> [)ISEOSALIRECYC I G FACILITY <br /> Q DK-DIXON SBURYENVIRONMENTAL Q16ERBANK OIL TRANSFER O YUMAYESLLC Q AMERICAN VALLEY wA6reexLINC <br /> 7300 CHEVRON WAY IM MORGAN RD. 5300 CLAUS RD. 6500 US HWY85 521 INDUSTRIAL DR STEM <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 853$5 LIVINGSTON.CA95334 <br /> 707-693-6008 209-541.182$ 209.863.8161 928.344-9829 209-667-8857 <br /> EPA#CAT080012602 EPA#CAL00039366D EPA#CAL000190016 EPA#AZR000521146 EPA#CALOW443004 <br /> rte• <br />