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0 In <br /> (. <br /> c( o n <br /> o <br /> — n <br /> Cn <br /> m <br /> cn <br /> z � <br /> 3AMERICAN VALLEY 16'0355 <br /> 0 0 <br /> � a � <br /> WASTE OIL, INC. Invoice Number: m <br /> 1711P.O.Bax 340•Delhi,CA 95315 p <br /> 7 y PH.1-800-732-4645•FAX 209.668-3880 rn <br /> (p EPA#CAR000272302 CD <br /> N 17ANDYSONIHE>f-r'l n:ul[.!.1l,uc:r,:..l. RANDYS ON 7 HE Si r.41*18JI 18LE _ ( OD <br /> BILL TO: 71pk rO.sEMItEnUL JOB SITE: 710 E YOSEMITE AVE CD <br /> MANTECA,CA Q+336 fAANTFCA,CA 95336 Invoice Date- � <br /> � D <br /> (D <br /> N)N <br /> O <br /> Phone Gustomer P.O. Terms C D EPA# 00 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST CIUANTrry PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used 011)Mlxed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 z <br /> Z 1 L <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> TERMS:invoices over 30 Days are subject to a 1.5%service charge Customer agrees to pay all legal fees i1 court action TOTAL <br /> becomes necessary to collect this invoice. 1 <br /> By signingherby certify That I have not mixed any of the waste described above with any other hazardous waste.the total halide content is LESS than 1,060 ppm.and the <br /> waste does not contain any PCBs.I have complied with the requiremenls of the applicable California used oil management regulation to determine this is true.l agreeto <br /> accept t8eadtlltlonal charges for the disposal of this waste if the information I have provided atic A this waste is incorrect. ` <br /> Generator's Certification:9y signing f certify that i ams large quantity generator.I cer ifythat I have a program in place lofeduce the volume and tonicity of waste generat- <br /> ed to the degree I have determined to he economically affordable and that I have selected the practicable method of treatment,storage,or disposal cunently avaiiable to me <br /> which minimizes the present and future threat to human life and the environment:Or,if I am a small quantity generator i have Gude a Goad faith 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 Genesi that generators shipment of used oil may be transported to a faciiity that is required to comply with lederel <br /> regulations applicable to management of used oil,but that is not required to Comply with the more stringent requirements applicable to Aazardeus waste management facili- <br /> ties.California facilities that handle or process used oil are required to meet those more stringent requirement,and someout-ol-state facilities mat process used oil also meet <br /> those requirements,engineering certifications of tank integrity,and financial assurances for closure and accidental releases.It is lawful to send used oil to cut of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <br /> This notilication is for information purposes only, <br /> By both parties signing this Invoice it will serve as an agreement that American valley Waste Oil will submit confirmation for(cedain waste streams}to the 9"Afemr thattheir <br /> waste has been transported to a licensed treatment or transfer facility. <br /> 3ENERATORI <br /> DRIVER AUTHORIZED PATE <br /> SIGNATURE, DATE: SIGNATURE: <br /> DISPOSAL/RECYCLING FACILITY <br /> 0 DK-DIXON ty r+ BURY ENVIRONMENTAL 0 RIVERBANK OiLTRANSFER CFR C)GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD 5300 CLAUS RD. 2035 E.15TH ST. 1640 N.BROADWAY <br /> DIXON CA 95620 CERES,CA 95358 RIVERBANK,CA 95367 LA,CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 209341.1825 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPAI CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br /> n <br /> MPC 17011161 0 <br /> Q <br /> 00 <br /> 00 Q <br /> ((D <br /> (D f` <br /> W J O <br /> Q <br /> W fT <br /> O <br />