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AMERICAN VALLEY 179877 WASTE OIL, INC. Invoice Number: P.O.Box 340•Delhi,CA 95315 PH. 1-800-7324645•FAX 209-668-3880 EPA#CAR000272302 EAST BAY CLARKLIP1' u[ BILL TO: 4701 OAKPORT ST JOB SITE: 1813 l3AY AT i3LVD r Invoice Date: OAKLAND,CA 946014906 1813 MOF.CTI 53 MANTECA,CA 95896 Phone 209.4 4M7,JENIFER Customer P.O. Terms EPA# CID.D. CAL000394327 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST ANTf1Y 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 Compliant Drained Used Metal Oil Filters OIL COLLECTI ON FEE q TERMS: Invoices over 30 Days are sub)ect to a 1.5%service charge. Customer agrees to pay all legal fees it court action TOTAL becomes necessary to collect this imroice, s By signing I herby certify that 1 have rot mixed any of the waste described above with any other hazardous waste,the total halide content Is LESS than 1,ow ppm,and the waste does not contain any PCBs I have complied with the requirements of the applicable Califomla used oil management regulation to determine this Is iris.I agree to accept the additronal charges for the disposal of this waste U the inion nation I have faoWded about this waste Is incorrect. Generator's Certification:By signing I certify that if I am a terga quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste goneat- ad 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 which mink&es the present and future threat to human IUs and the environment:Or,U I am a small quantity generator,l have made a Good fahh effort to minimize my waste generation and select the waste management method that is available to me that I can afford. American Valley Wase Oil hereby advises the above Generator that gencratons shipment of used oil may be transported to a facility that is required to comply with federal 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- 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 Ihose 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 that comply only with federal used all management standards and not these more stringent requirements. This notification Is for Information purposes only. 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 waste has been transported to a licensed treatment or transfer facility. GENERATOR/ DRIVER 01 AUTHORIZE 'Y SIGNATURE: '� DATE,2 ( /a SIG NA DATE:d DISPOSAL I ECYCLING FACILITY O DK-DIXON G-ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O YUMA YES LLC O AMERICAN VAI LFV WASTE OIL,INC 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA95367 YUMA,AZ 65365 LIVINGSTON,CA 95334 707-693-6008 209-541-1825 209.863-8181 928.344.9828 209.667.8857 EPA#CAT060012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 MPC(712016)