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AMERICAN VALLEY 186320 <br /> WASTE OIL, INC. Invoice Number- <br /> P.O. <br /> umber-PO.Bax 340•Delhi,CA 95315 <br /> PH. 1-800-732-4645•FAX 209-668-3880 <br /> EPA#CAR000272302 <br /> -ar <br /> BILL TO; VAN DEPOL JO$SITE; VAN DE POL-RPON IWVoice rate: <br /> PO BOX 1107 816 S FRONTAGE RQ <br /> STOCKTON.CA 95201 RIPON,CA 91366 <br /> Phone Customer F.0. __ Teretes EPAf1�r�esttep: <br /> 209 471-5«57 FC+titV t-lon �CpL400258236 <br /> PRODUCTX1410110M10iPTION WASTE MANIFEST iQUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> .T SO - tW6_5_ 2 <br /> i <br /> TERMS; Invoices over 30 Days are subject to a 1.6%service charga. CustomerA13YtAN�9�fees if court action TOTAL <br /> becomes necessary to coWitis 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 LOW Ppm,and the <br /> waste does not cattaInarty PC85.1 have complied with the requirements of the applicable California aced oA managoment regulation to determine this is true,I agree to <br /> accept the addittmal charges lzt the h= <br /> cf this waste if the mfonnatfon I have provided about this waste is frrterrect. <br /> Generators camAaaeon:Ely agrNng I Certify that of I am a Varga quantity generator,f certify that f have a program in Place to reduce the Volume,and.toxielt of waste . <br /> ad to the y girt.At.d�gre�I have determined to be econankalq�affordable and that i have selected the MaclbaWe method of aeatmartt,storage,o disposal cuiteMly aVellaW9 to me <br /> which minimizes the present and future threat to human We and the environment:Or,if 1 am a"quantity generator,I have Trade a Good faith effort to minimize my waste <br /> generation and select the waste ntaragernent method that is available to me than Cart alhap. <br /> American Valley Waste 01 h eraby advises the above Generator that generators shipment of used oil maybe Transported to a fatality that is required to comply with federal <br /> reg4lat",epplipbia to frtanaflemart of used ON,but that I$riot required to cattily,with the more stringent tequUamenis applicable to hazardous waste management facili- <br /> ties.CaiBan is facilities that handle or process used no are required to moat those mote amngem requirement,and some out-of-state iaclli6es that plttoeSS used oil also meat <br /> fhoso 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 laoilitles <br /> that comply only with led"used oil rnam9ernent standards and not those none stringent requirements. <br /> This notification isfor information only. <br /> By both partes signYlq Y it will save as an agreement that Arne OM Valley Wasla oil will submit oWirmation for(certain Waste Streamsi to the generator that their <br /> waste has heed tra t icensad treatment or trialsterfacoty. <br /> DRIVER GENERATOR/ <br /> SIGNATURE: / 'DATE:1a�ti"AO SIGNNAATURE: <br /> (7 DATE:1p'34 <br /> DISPOSAL/RECYCLING FAQII rev <br /> Q DK-DIXON U ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER YUMA YES LLC Q AtaES"N VALLEY WASTE LNL.INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD- 6"CLAUS RD.. 6500 Us HWY 95 521 INDUSTRIAL OR STE M <br /> DIXON,CA 95620 CERES,CA 95359 RIVERBANK, CA95367 YUMA,AZ 85365 LIVINGSTON,CA 96334 <br /> 707.693.6008 209-541.18.25 209.863-8181 928344-9828 209.667.8857 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC 1712nta) <br />