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I AMERICAN VALLEY 173062 WASTE OIL, INC. Invoice Number: P.O.Box 340•Delhi,CA 95315 PH. 1-800-732-4645•FAX 209-668-3880 EPA#CAR000272302 BILL TO. EAST SITE: 8S� Y C RK IIFT Invoice Date:oAY LVD OAKLAND,CA 946014905 -1 MANTECA,CA.953%, �4 Phone Cust P.O. TBAs EPA#SVS` 209-465987 JEAIIF C.O.D. I CAL000394327 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 NON-RCRA Waste Liquid Used Oily Water 223 Drained Used Oil Filters TERMS:Invoices over 30 Days are subject to a 1.5%service charge.Customer erg Tergal fees H court action TOTAL tx'J becomes necessary to collect this invoice. By signing I herby certify that I have not mixed any of the waste described above with any other hazardous waste,the total hellde content is LESS than 1.000 ppm,and the waste doss 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 socapi the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect. Genxetor's Certlncceton:By signing I certify that t I am a large quamlty,generator.I certify that I have a program in place to reduce the vokcne and toxkdy of wasto generat- ed to the degree I have determined to be eccnomk v*affordable and that I have selected the practicable meted of treatment,storage,or disposal cunantty available to me Which minin izes the present and future threat to human Iffe and the environment I%t I am a small quantity generator,I have made a Good faith effort to minimize my waste generation and select the waste management method that is avallable to me that I can afford. American Valley Waste ON hereby advises the above Generator that generators shipment of used oil may be transported to a facility that Is required to comply with federal regulations applicable to management of used all,but that Is not required to comply with the more stringent requirements applicable to hazardous waste management facili- 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 those requirements,engineering cartliications of tank integrity,and financial assurances for closure and accidental releases.it Is lawful to send used oil to out of state facilities that comply only with federal used oil management standards and not these more stringent requirements. This notification Is for Information purposes only. By both parties signing this invoice it vriil serve as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the generator that their waste has been transported to a licensed treatment or transfer facility. GENERATORI DRIVER AUTHORIZED SIGNATURE. DATE SIGNATUAE DATE DISPOSAL/RECYQUNG FACILITY O DK-DIXON ASBURYENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.1STH ST. 1640 N.BROADWAY DIXON,CA 95620 CERES,CA 95358 RIVERBANK CA 95357 LA,CA 90021 STOCKTON,CA 95205 707-693.6008 209.541.1825 209-863-8181 213-746-0237 818-770-2577 EPA#CAT080012602 EPA#CAL000393680 EPA#CALDDOIO0816 v EPA#CAL000270577 EPA#CAL000417316 MPC(712016)