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AMERICAN VALLEY 1667 - 37 <br /> WASTE 01L � INC : Invoice Number ; <br /> P. O. Pox 340 • Delhi , CA 953.15 . . <br /> PH . 1 -800-732-4645 • FAX 20 -668- 3880 <br /> EPA# CAR000272302 <,1 M <br /> OIAPd T i ! f_ GMTTIRE 14 .. <br /> 330 KETTL,EMAN LN rWol) K'` TTL.EMAN LN <br /> BILL TO : LDI „ CA 86240 JOB SITE: LODI „ CA 95240 Invoi <br /> �' ce Dare. <br /> Fehr. <br /> 2a -. z BO <br /> Phone Customer P. O , Terms EPA# s, <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODEN. <br /> 40 L <br /> 221i1lMixed Oils NON- RCRA WasteLiquid Used O ' ' i' � I r - <br /> i <br /> NON -RCRA Waste _Liquid Used Antifreeze 133 <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 if ourt action TOTAL � ` <br /> becomes necessary to collect this Invoice . l <br /> By signing 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 ,000 ppm, end the <br /> waste does not contain any PCBs. i have complied vkh the requirements of the applicable California used oil management regulation to determine this is true. I agree to <br /> accept the additional charges for the disposal of this waste If the Information I have provided about this waste is incorrect. <br /> Generator's Certifieadon: By signing f 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 eccnornloallyaffordable and that I have selected the practicable method of treatment, storage, or disposal cuman%r available to me <br /> which minimizes the present and future threat to human life and the environment: Or, i` I am a small quantity generator, I have made a Good faith effort to minimize rriy 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 maybe transported to a facility that is required to comply with federal <br /> regulations apalieable to management of used oil, but that is not required to comply with the more stringent requirements applicable to hazardous waste management facili- <br /> ties. Callfornia facilities that handle or process used oil are required to meet those more stringent requirement, and some out-of-state facilities that process used oil talso 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 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 Valley Waste Oil wi'I submit confirmation for (certain waste syeams) to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility, <br /> GENERATOR/ 4 ; f1 <br /> I t`• ",'t r , tT AUTHORIZED v 1 <br /> DRIVER % ! ': 4 � - DATE: <br /> SIGNATURE ' . s ; t ' �...a :v' . (., �'' '' DATE ' r, ") SIGNATURE : LJ <br /> DISPOSAL / RECYRECYCLING. FACILITY j <br /> 0 DK-DIXON ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR 0 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, CA95367 LA, CA 90021 STOCKTON, CA 95205 <br /> 707-693-6Q08 209-541 -1825 209863-8181 213.746.0237 B18-770-2577 <br /> EPA# CATOSOO12602 EPA# CAL000393680 EPA# CALO00190816 EPA# CAL000270577 EPA# CAL00041. 7316 <br /> MPC (712016) <br /> 91d LO£L69£ eat} }unoosip tuiri0 e8 £ * 60 ` 8 L L £ PO <br />