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i <br /> AMERICAN VALLEY 174752 <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: EAST BAY Ci.ARKLIFT-CHH, )OB SITE: EAST SAY CLARKLIFT I` oice Date: <br /> 4701 OAKPORT ST 1819 MOFFAT ELVD <br /> OAKLAND.CA 946014906 MANTECA,CA 95396 <br /> Phone Customer P.O. erms EP <br /> 208-455-B9137,�i'�IIFE�t V.!°ro C.OA M0003 327 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST I PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 t _ <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 _ <br /> rComplii.,ant Drained Used Metal Oil Filters f <br /> lAz A6TE H CK iift-A65Qf�BBJT 8 AN 6 l31 L5 O[TOP U.N LER T STEEL.RE <br /> TERMS:Invoices over 30 Days are subject to a 1,54x+service charge.Customer legal fees 6 court action TOTAL yr <br /> becomes necessary to collect Mls invoice. !1 <br /> By signing I herby certify that 1 have not mixed any d the waste described above with any other ham waste,the total halide content k LESS t7,c1,030 v n, the <br /> han the requirements of the applicable California used oil management regulation to determine tibia Is true.I seise to <br /> waste does not wntaM any PCBs.I have complied with <br /> 1 accept the add tonal dhaiges for the disposal of gl a waste if the information I have Provided about this waste Is Incorrect. <br /> Genemtark Certlficatlon:By signing I oerlily that if I am a large quantity generator,I cert"y that I have a program in Piece 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 m"mimizes the present and future tMeat to ftdmhelr life artd the environment:Or,if I am a arnail quantity generator,I have made a Good faith effort to minimizo my waste <br /> generatlon aril select the waste management method that t'available to me that 1 can atbrd. ����to a fadity Mat le required to campy with fetkrel <br /> lvnerican'allay Waste OII hereby advises Gn above Generator that generataa shipmerd of used oil may applleahls m hazanfoua waste management ty <br /> epP ble tmanagaTsnt of used ou,but thtiesmiefaciliescthat n7 with <br /> fgrederal used dl merit iganx^1 I=terdards old rot 1 these more sidn9enicraqulremem idmN"I releases.It is lawful to send used dl to out of state fecllltles <br /> This notification is for information purposes only. <br /> By both parties signing this invoice it will serve as an agreement that Amw�an Valley Waste 011 will submit confirmation for(certain waste streams)to the generator that that! <br /> I waste has been transported to a licensed treatment or transfer facility- <br /> GENERATOR! <br /> DRI' / f♦OREEO _ /DATE: 6IG URE: _DA rDISPG L G FACILII`1O DK-DIX O ASBURYENVIRONMENTAL O RlVERBANKOILTRANSFER O YUMAYESLLC O AMEAtIMC <br /> 521 IE M <br /> 7300' RON WAY 1920 MORGAN RD, 5300 CLAUS RD. 6500 US HWY 95 LIVINGSTON.CA 95334 <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA.AZ 85365 7 <br /> 707-693.6008 209-541.1825 209-863-8181 928-344-9828 EPA#209-667-585 445004 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#GALOW19t0816 EPA#AZA000521146 <br /> MPC(7Q01 8) <br />