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'- MERICAN VALLEY 170953 <br /> Q� ��&5--'l 5-6 _ DD'i"9 f 7Invoice Number: <br /> �\ <br /> 01-112o <br /> y12 o WASTE SIL, INC. <br /> `` P.O.Box 340•Delhi,CA 95315 <br /> fMa AV-,C�U lQ- qPH.1-800-732-464A5 <br /> CA5 -FAX <br /> X209-668-3880 <br /> W-e Q Z EAST BAY CLARKLIFT-CHM 02 EAST BAY CLARKLIFT / r/ <br /> BILL TO: 4701 OAKPORT ST JOB SITE: 1813 <br /> 13 MOFF T BLVD Date: <br /> AN <br /> OAKLD,CA 946014906 <br /> Styes Rep: <br /> Phone Fustorner P.O. s EPA# CAL�0394327 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST UANTfIY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 95 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> LES TAX-- <br /> TERMS: Invokes 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 colied this invoke. <br /> By signing I herby certify that I have not mixed any of the waste described above with any tither hazardous waste,the total halide content is LESS than 1,000 ppm,and the <br /> waste does not contain any PCBs.I have compiled with the requirements of the applicable Ceiifomia used oil management regulation to detemline this is IMI agree 10 <br /> .If 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 1 certify that If I am a largo quantity gencrator,I certify that I have a program in piece to reduce the volume and toxicity of waste generat- <br /> ed to the degree 1 have determined to be economic*affordable and that 1 have aeleoted the practicable method of treatment,sbrage,or disposal currently available to me <br /> which minimizes the present and future threat to human life and the erwimnment Or,If I am a small quantity generator,I have made a Good falth effort to minimize my waste <br /> generation end select the waste management method that is available to rhe that I can afford. <br /> American Valley Waste Oil hereby advises the above Generator tat generators shipment of used ail may be transported to a focgity 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 fedl- <br /> ties.California facilities that handle or process used til are required to meet those more stringent requirement,and some out-of-slate facrlitles that process used oil also meet <br /> twee requirements,engineering certifications of tank integrity,and financial amararces 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 mora stringent requirements. <br /> This notification is for inforat?on purposes only. <br /> By both parties signing this invoice a will serve as an agreement that American Valley Waste Oil will submit rwnfirmmhan t 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: - DATE: IGNATURE' DATE: 5 <br /> DISPOSAL/RECYCLING FACILITY <br /> O DK-DIXON ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER C CFR C GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.15TH ST. 1640 N.BROADWAY <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 LA,CA 90021 STOCKTON,CA 95205 <br /> 7D7-693-6008 209-541.1825 209.863-8181 213.746-0237 818-770-2577 <br /> EPA#CATD80012602 EPA#CAL000393680 EPA#CAWW190816 EPA#CAL000270577 EPA#CALOOD417316 <br /> MPC vnotel <br />