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AMERICAN VALLEY 195305 <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 /> EPA# CAR000272302 <br /> BILL TO: JOB SITE: _L4Z1__6_,Alz_/ <br /> Invoice Date; <br /> Phone Customer P.O. Terms <br /> __;]:erms <br /> PRODUE�'SNPAG DESCRIPTION WA MANIFES__TQUANTITY Pii� 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 /> 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 /> 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 than 1,000 prim,and the <br /> wast does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.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 if I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generat- <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:Of,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 oil 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 managamentfacili- <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 all also meet <br /> those requirements.engineering cart fications,of lank 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 it 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 /> (3ENERATORt sC <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE: SIGNATURE: <br /> C/7 IL DATE: <br /> \ Z <br /> DISPOSAL/ RECYCLING FACILITY <br /> 0 DK-DIXON 0 ASBURY 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 STEM <br /> DIXON,CA 95620 CERES,CA 95358 RIVERIBANIK, CA 85367 YUMA,AZ 85366 LIVINGSTON,CA 95334 <br /> 707-693-6008 209-541-1825 209-863-8181 928-344-9828 209-667-8857 <br /> EPA#CAL0001 9081 6 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC M206) <br />