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.� <br /> AMERICAN VALLEY 176329 <br /> WASTE OIL, INC. <br /> Invoice Number <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PM. 1-800-732-40145 • FAX 209-668-3880 <br /> EPA# CAR000272302 �y f V, l <br /> JOB SITE: cHINCHIOLO Invoice Date: <br /> BILL TO: CHlhdGHlOW 4799 N. JACK TOI�jE RD <br /> 4799 N, JACK TONE RD grpGl�Td(�I,CA 9S240C74G1iT01d,GA 95 216 X FAIRCHILD <br /> Customer P.O. Terms EPA# <br /> Phone .L'U9-4U1-6403 noel 1t r AL0003FA917 <br /> 1111,ln-47 J . n I <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST QUANTITY PRICE AMOUNT <br /> WASTE <br /> CODE <br /> � .. <br /> NON-RCRA 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 /> Compliant Drained Used Metal Oil Filters <br /> Qllr(OLLL(:I IUI\I F10E <br /> TERMS: Invoices over 30 Days are subject to a i.S°o service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> y l <br /> becomes necessary to collect this invnlce. <br /> Esigning I herby certify that I have noE mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the <br /> waste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree to <br /> accept the additional charges for Bre 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 generat- <br /> ed to the degree I have determined to be economically affordable and that 1 have seieeted the practicable method of treatment,storage,or disposal currently avaiiable to me <br /> which minimizes the present and future threat to human lite and the envlronmi or,if k am a small quantity generator,I have made a Good falth 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 oil may be transported to a facility that is required to comply with federal <br /> regulations applicable to management of used oil,but that is not required to corn iy with the more stringent requirements applicable to hazardous waste management facili- <br /> 10* <br /> ties.California faciht es that handle or process used oil are required to meet those more stringent requirement,and some out-of-state facilities that process used oil also meet,' <br /> those requirements,engineering certifications of tank integrity,and financial assurances for closure and accidentak releases.It is lawful to send used oil to out of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <br /> This notification is for information purposes only. <br /> By both parties signing this Invoice it will serve as an agreement that American Vailey Waste Oil will submit confirmation for[certain waste streams]to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> AUTHORIZED i f <br /> DIGNATURE: ` I' y OAT6: [� tl SIGNATURE; DATE: <br /> DISPOSAL 1 REC0SBUFY <br /> I�NG FACILITY <br /> Q DK-DIXON ENVIRONMENTAL '``)"ftIVERBANK OIL TRANSFER O YUMA YES LLC Q AMERICANMLLEYWASTE OIL,INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM <br /> DIXON.CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 <br /> 707-693-6x08 209-541-1825 209-863-8181 928-344-9828 209.667.BB57 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPAu CRL000443004 <br /> MPC E7rM161 <br />