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AMERICAN VALLEY 185 097 <br /> WASTE OIL , INC . Invoice Number: <br /> P, O , Box 340 a Delhi , CA 95315 <br /> PH , 1 -800-7324645 o FAX 209-668- 3880 <br /> EPA# CAR000272302 / <br /> BILL TO : I0EALEA8ELATHR (A;t1 JOB SITE: IDEALEASE Invoice Date: <br /> $537 N , OOLOENSTA i iz 2400 LOUiSE AVE <br /> TURLOCK , CA 65382 LATHROP , CA 95330 <br /> 1M OIL <br /> Phone Customer P,O , Terms EPA#- 4liv " 4ve <br /> ett�- 67t300:i7 SN4tNE. <br /> tJstsODa t< CAL00037WU <br /> PRODUCT RIPTION WASTE MANIFEST QUIT UNT <br /> "'� , • � C�:. a '� l� <br /> CODE <br /> NOWRCRA Waste Liquid Used Oil/Mixed Oils 221 CCT 2 2 2010 <br /> NOW RCRA Waste Liquid Used Antifreeze 133 <br /> ENVIR NMENTAL HEALTH <br /> NON - RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> f- Rt3t�Hl i Li T , r - <br /> r. t <br /> TERMS : Invoices over 30 Days are subject to a 1 .5% service charge, Customer dlllegal fees it court action TOTAL <br /> becomes necessary to collect this invoice , <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, and the <br /> waste does riot 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 /> acic pW the additional charges for the 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 general- <br /> ed to the degree I have determined to be economically affordable and 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 hurnan life and the environment: Or, if I am a small quantity generator, I have made a Good 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 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 comply with the more stringent requirements applicable to hazardous waste management facili- <br /> ties, California facilities that handle or process used oil are required to meet those mora 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 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 ptfrposes only. <br /> By both parties signing this '�olc �1 will serve as an agreement that American Valley Waste Oil will submit confirmation for (certain waste sVearnC.) to the generator that their <br /> waste has been transport to a ensed treatment or transfer facility. <br /> GENERATOR/ <br /> DRIVER r' AUTHORIZED .. £ <br /> SIGNATURE: DATE : SIGNATURE: j , ! t i DATE : <br /> DISPOSAL / RECYCLING FACILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O YUMA YES LLC Q AMERICAN VALLEY WASTE OIL, INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD . 5300 CLAUS RD . 6500 US HWY 95 521 INDUSTRIAL DR STE M <br /> DIXON , CA 95620 CERES , CA 95358 RIVERBANK, CA 95367 YUMA , AZ 85365 LIVINGSTON , CA 95334 <br /> 707.693. 6008 209-541 . 1825 209-863.8181 928.344.9828 209-667-8857 <br /> EPA# CAT080012602 EPA# CAL000393680 EPA# CAL000190816 EPA# AZR000521146 EPA# CAL000443004 <br /> i <br /> MPC ( 7/2016) <br /> I <br />