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06 / 11 / 2021 1 : 47 PM FAX 2099488625 AMCE SAW IRI 0006 / 0007 <br /> AMERICAN VALLEY <br /> WAVE OIL , INC " Invoice Numbers <br /> P. O . Box 340 a Delhi , CA 98815 <br /> PH , 1 -800-7324645 • FAX 209-668W3880 <br /> EPA# CAR000272302 <br /> BILL TO : <br /> JOB SIT21I <br /> Invoice Date . <br /> Phone Customer P, O . Terms EPA `. <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NOWFICRA Waste Liquid Used Oil/Mixed Oils 221 V <br /> NOWRCRA Waste Liquid Used Antifreeze 133 <br /> NOWRCRA 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. Cusfomcr agrees to eery ali legal tees if court aclfnn <br /> becomes necessary to collect this invoice, TOTAL <br /> By sinning I herby certify that I have not miw%„d any of the waste. deucribarl above with any other hazardNis waste, file total halide content is LES.'.; than 1 JI00 ppm , and the <br /> wssto does not contain ally PCBs. I have onnlplled with [tie requirements 01 the applicable Calitornia used oil manctcicment rogulatlnn to determine this is true. I agrou to <br /> accept (tee additional chartics for1ho dispos,3i of this waste, if the information I have provided aUout this Waste is incorrect. <br /> Genorator's Corlification: By signing 1 cettity that if I aril a large quantity riunerator, I certify tl)ut I have a progrin) in place to reduce (he volUrtto and toxicity of waste genorat- <br /> et1 to the degree I havo determlilud to he oconomieaiiy affordable and that I have selected ilia practicable method of trea(rnent, storage, or disposal currently availshfe to me <br /> which minimizes the. present arld future threat to human life and the environment: Or, if I a;n a smali quantity generator, I have matte a Goad faith ell to minimize my waste <br /> generation and select the waste management method that Is avafl.9hlo to me that I can atiurd. <br /> American Valley Waste Oil humby advisus the suave Generator that generator; shipment of used oil may he transported to a tacility that is required to comply with fedoral <br /> regulations applie%aule to management of used fill, but that is trot regUirud to norlrply with (hc more stringent requirements applicable to ha?ardour waste manaC3oment tauili- <br /> lius. California facilities that handle or prncass used ail are rs:quired t0 rnuet thogt: more stringent requirement, and some, out-Of-stiQc facifitlou that prOGeus useal oil also rYrget <br /> those requirements, Pili)ineering cortificatifins of tank integrity, tend finanokd assurer•ruu,s for cks;ure an(! aucidentni rcieeaes. It is lawful to send u:ad oil to c)ut of state: <br /> that Wmply only with fedcarrtl used nil rnanagemont standards and not these more stringent rcquiremonts, facilities <br /> This notltI<:u ion is for information purposes only. <br /> By Both partiou signing this invojex, it will serVo as sn A!.1reement litat American Valley Waste Oil will submit confirmation for (certain waste streams) it) the genertter that (heir <br /> waste: ryas been lransportod to a licensed trekPilfrient or transfer t1diity. <br /> DRIVER GENERATOR/ <br /> SIGNATURE: AU'rHCRIZED <br /> DATE' SIGNATURE: DATE : <br /> ”- ISPOSAL I RECYCLING FACILITY <br /> DK DIXON 0 ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER Q CFR 0 GLOBAL MATERIAL MGMT <br /> 7300 CHPVRON WAY 1920 MORGAN RD, 5300 CLAUS RD , 2035 E. 15TH ST, IND N. BROADWAY <br /> DIXON , CA 95620 CERES , CA 95356 RIVEHE3ANK, CA 95367 LA CA 30D21 r <br /> 707 693-6008 209 541 - 1825 STOCKTON , CA 95208 <br /> 209-863-8181 213-746-0237 818-770-2577 <br /> EPA# CAT080012602 EPA# CAL000393680 EPA# CAL000 190816 EPA# CAL000270577 EPA# CAL000417316 <br /> i <br /> I <br /> E <br /> i <br />