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09/18/2013 14:56 120933341873 <br />AMERICAN VALLEY', <br />WASTE OIL, INC. - -a <br />P.O. Box 340 a, Delhi, CA 95315 -),18 2013 <br />PH. 1-800732-4645 - FAX 209-668-3880 <br />EPA# CAL0008-27878 <br />.'ENT <br />JOB -SITE: <br />1. 1 12 A <br />FLAGCITY CHEVRn" <br />BILL TO: <br />6.'A4!,? -I CAPITOI� AV(-,: <br />PAGE 03/09 <br />940 <br />Invoice Number: <br />Invoice Date: <br />Phalle <br />Customer P.O. <br />IPPAP`(,-�(. I <br />VALXIM <br />Ll prlw� <br />P RCb UCr8Hj'FiPl"NG'DE=SCRIPTION <br />MANIFEST <br />QUANTITY, <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />INION-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />,223 - <br />Drained Used Oil Filters <br />TERMS: Invoices over 3o,Days are subject to a 1.5%sarvice charge, Cu_,3wmer agrees to pay all legal fees H court action <br />TOTAL <br />becomes necessary to co,oL , this Invoice, <br />- <br />By signing I herby certify that I have not mixed any of the waste described above with any other ha7ardowq waste, the total halide content 15 I,F55 zhan,1,000 ppm, <br />and the waste does not contain any Kgs. I have compllpd with the requirements of the applicable California used oil management regulation to determine this Is <br />true, i agree to accept the OdltionRl charges fortha disposRi of this waste If the Inform;Ttlon I have provided about this waste IS incorrect, <br />Generator's Cer*lflcatlom By signing I ccrr.IfV that if I am a largo quantity generator, I certify that I have a program in place to reduce the, voii.irne and toxicity of waste <br />Fenprated to the degree I linve drtprmlnf,,d to be economically affordable and that I h.ive ;eIected the practicable method of treatment, storage, or disposal currently <br />available to me which rnfnlmizos the present and future thrrml: to human life and tho environment: or, If I am A small quantity generator, I have made a good falth <br />effort to rninimlve my wn.qte generation and select the waste management method that Is available to me that f ran afford, <br />By both parties signing, this Invoicn, it will serve ns an agreement that American Valley Waste Oil will submit confirmation -for (cprtgln waste streams) to the generator <br />that their waste has been transported to a llrcnspd treatment or tra nsfer, facility. <br />GENERATOR/ <br />DRIVER AUTHORIZED <br />SIGNATURE. , DATE !;P SIGNATURE: DATE:,� <br />QI.SPQ$ Lik,RECYCLING FACILITY <br />0_IDK-DIXON 0 CF=n 0 UNITED ENTERPRISES CORP <br />7300 CHEVRON WAY 2035 E. 15TH u-1 11190 PENROSE ST. <br />DIXON, CA 95820 LA, CA 90021 SUN VALLEY, CA 91352 <br />707.693-6008 212-746-02V 818-787-2649 <br />EPA# CAT080012602 SPAR CAL000270577 EPA4 CAI,000379059 <br />