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AMERICAN VALLEY 191431 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340 - Delhi, CA 95315 <br /> PH, 1-800-732-4645- FAX 209-668-3880 <br /> O; EPA#CAR000272302 <br /> BILL T <br /> NTRALAUTORSPAIRJOB SITE: ']� <br /> 461 POWERS AV E '16�1'6 POVCEPS AVE Invoice Date: <br /> MANTECA,CA 96336 Y� MOFFETT <br /> MANTEt A.�,^ t6336 <br /> 210 OIL 4M AF <br /> -ARC <br /> f80 EDWARD ,,iA <br /> Phone <br /> ustomer RO. Terms EPA# <br /> 209-825-3081 Net 15 Days AL 001567176 <br /> Days <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT] <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> . 35 <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 /> 0 L C QLLL QN f E C <br /> SAL T AA- <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge Customer agrees to pay all legal fees if court action TOTAL <br /> I becomes necessary to collect this 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 than1,000 ppm,and the <br /> waste does not contain any PCBs.I have compiled with the requirements of the applicable California used oil management regulation to determine this is live.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 /> Generator's Certification:By signing I certify that it I am a large quantity generator.I certify that I have a program in place to reduce the volume and toxicity of wastegenaraii- <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 shipment of used all may be transported to a facility that 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 facili- <br /> ties,California facilities that handle or process used oil are required to meet those more stringent requirement,and some out-of-state facilities that process used oil also meet <br /> those 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 facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <br /> This notification is for information purposes only. <br /> By both parties signing this invoice A will serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR, <br /> DRIVERAUTHORIZED <br /> SIGNATURE: DATEI, -4-,)LI SIGNATURE: DATEL7 <br /> DISPOSAL/ REQYQ1 ING FACILITY <br /> 0 DK-DIXON V"A'SBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 YUMA YES LLC 0 AMERICAN VALLEY WASTE OIL.INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STE MI <br /> DIXON,CA 95620 CERES,CA 96358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON.CA 95334 <br /> 707-693-6008 209-541-1825 209-863-8181 928-344-9828 209-667-8857 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC(712016) <br />