Laserfiche WebLink
AMERICAN VALLE CEIVE � �" 1 <br />A� � C �+ <br />WASTE OIL, INC nvotce Number: <br />p O. Sox 340 •Delhi, <br />CA 95315 OCT 1 6 LUIJ <br />`ENVIRONMENTAL ' <br />PH. 1 800-732-4645 • FAX 209-668-38 <br />iAw C- A <br />iL000827878 <br />- - ' HEALTH DEPARTMENT <br />,TOB SITE.: I t`�i-9,41 at'4 Invoice Date: <br />BILL TO: k Itne�^ 1 <br />-+ `•:�,I i `t" f,: fi'•4;~ 11f�;;4E'd <br />Customer P.O. berms rAl'rllvT'i <br />Phone <br />ra.1'.) <br />}r't�� ""> .. �:a ,► tc ;,I. MANIFEST QUANTITY PRICE <br />PACO) CT SHIPPING DESCRIPTION WASTE <br />CODE _ <br />! 221 <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Drained Used Oil Filters t`-•tfs"'"'rte-? — <br />I <br />ERMS. invoices over 30 Days are subject to a 1.5% service charge. <br />agrees court <br />to pay all legal fees If action ' TOTAL <br />AMOUNT <br />7 -- <br />becomes necessary to collect this invoice. <br />By signing I herby certify that I have not mix Wath the requerements of he applicable cableaifhalideous waste, the total <br />the wsteescribd above with any other California used oil management regulationion to determine this <br />and the waste does not contain any PCBs. I have compiled <br />true. 1 agree to accept the additional charges for the disposal of this waste Ifthe information I have provided about this waste Is Incorrect. <br />fy that I have a program in place to reduce the v <br />ume and toxicity of <br />aste <br />Generator s Certification: By signing 1 cPrtlfy that ieconomicallarge <br />ly affordity ableenerator, I and that I have selected the practicable method of treatment, tlo age, or disposal urJ ently <br />generated to the degree 1 have determined to ber, if enerator, I have made a good faith <br />available to me which minimizes the present and future threat human management method that is available Oto me that Iscaniafford. g <br />effort to minimize my waste generation and select the waste <br />8y both parties signing, this invoice it will serve as an agreement that American Valley Waste Oil wll I submit confirmation for (certain waste streams) to the generator <br />that their waste has been transported to a licensed treatment or transfer facility. <br />GENERATOR/ <br />AUTHORIZED <br />DRIVER DATE: SIGNATURE <br />SIGNATURE: _-- <br />DISPOSAL / RECYCLING FACILITY <br />O CFR <br />0 UNITED ENTERPRISES CORP <br />0 DK-DIXON <br />2035 E. ST. <br />11190 PENROSE ST. <br />7,900 CHEVRON WAY <br />LA, GA 900TH <br />LA, CA 90237 <br />SUN VALLEY, CA 91352 <br />DIXON, CA 95620 <br />707-693-6008 <br />EPA# 6-0237 270577 <br />818-787.2549 <br />EPA# CAL000379059 <br />EPA# CAT080012602 <br />DATE: .-) �- <br />K&Pr. 1011201' <br />