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06 / 11 / 2021 1442 PM FAX 2099485625 AMCE SAW 0002 / 0005 <br /> AMERICAN VALLEY 17 9 g 5 8 <br /> f WASTE OIL, INC . Invoice Number , <br /> P. O . Box 340 • Delhi , CA 95$ 15 <br /> PH . 1 -8007324645 FAX 209-668-3880 <br /> EPA## CAR000272302 <br /> ILL TCI : ACME SAW JOB SITE: ACME SAW Invoice Date: <br /> 1 '„. 044 F , MAii.l 12W E, MAIN RT <br /> TQGI<:T 71V , CA 95206 <br /> X. AIRPORT <br /> STOCKTON, Cry X6206 <br /> Phone 209+ 361 . 1917 JOHN Customer P. O . Terms EPA# A Bert e� lting <br /> N> t30 s AL000178438 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON - RCRA Waste Liquid 'Used Oil/Mixed Oils' 221 vj � w <br /> NON - RCRA Waste Liquid Used Antifreeze 103 <br /> NON -RCRA Waste Liquid Used (Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters � . <br /> OIL, ,COLLECTION FEE <br /> TERMS: invoices over 30 Days are subfect to a 1 ,50/9 service charge. Customer agrees to pay all legal fees if court action TOTAL � <br /> becomes necessary to collect this invoice. C f C <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 not Contain any PCBs. I have complied with the requirements of the applicable California used 'oll 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 /> r , 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 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 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 shipmont of used oil may be transported to a facilitythet 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 facllf- <br /> ties. California facilities. that handle or process used oil arca required to meet those more stringent requirement, and some out-of-State facilities that process used oil also meet <br /> thoso requirements, engineering certifications of tank inter rity, and financial assurances for Closure and accidental releases, It is lawful to send used oil to out of state faciiltles <br /> that comply only with fedora) used oil management standards and not theta more stringent requirements, <br /> This notification is for Information purposes only. <br /> By both parties signing thiB involce It will serve as an agreement that American Valley Waste oil will submit confirmation for (CGrtain waste['tesMajpth0 generator that their <br /> t waste has been transported to a licensed treatment or transfer facility, <br /> GENERATOR! <br /> bI41VE11 lie AUTHORIZED . ,, w. <br /> SIGNATURE ; �,, faAT ,% ,,� a �� SIGNATURE : DATE <br /> DISPOSAL / P.RCYCLING FACILITY <br /> 0 DK-DIYON e ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER ,C YUMA YES LLC 0 AMERICAN VALLEY WASTE OIL, INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD, 5300 CLAUS RD. 6500 U$ HWY 95 521 INDUSTRIAL DR STE M <br /> DIXON, CA 95620 CERES , CA 95358 RIVER8AN [f, GA 95867 YUMA, AZ 85365 LIVINGSTON, CA95334 <br /> 707-693-6006 209-541 - 18254 209=863-8181 928.344-9828 209-667-8857 <br /> EPA# CAT080012602 EPA# CAL000393680 EISA#' CAL000190816 EPA# AZR000521146 EPA# CAL000443004 <br /> MPC (7/9010) <br /> r ' <br /> c <br />