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AMERICAN VALLEY 183400 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O.Box 340 a Delhi,CA 95315 <br /> PH. 1-800-732-4645•FAX 209-668-3880 <br /> EPA#CARD00272302 <br /> BILL TO: EAST BAY CLAPKLiFT­C:HIaI C <br /> AY EAST JOB SITE: AST BLARTSLIFT /D? <br /> 4701 OAKPORT ST EBAY L BLVD Invoice ate: <br /> OAKLAND.CA 946014906 81 <br /> Phone 209-465-5987 jENiFER Customer P.O. Terms <br /> PA# <br /> I c CAL000594327 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> .rTr /l vp <br /> NON-RCRA Waste Liquid Used Antifreeze 133 z a ,� <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> OIL COLLECTION FEE <br /> `—•vr_> <br /> TERMS:Inv fps over 30 Days are subject to a 1.5%service charge.Customer agrees to pay all legal fees if co3_a�Fr�lo_nToT4LEcollect 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 t.CCo ppm,and the <br /> waste does not contain any PCBs.I have complied with the requirements of the applicable Celifomla used oil management regulation to determine this is true.I agree to <br /> accept the additional charges for the disposal of this waste N 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 Pmgrem In place to reduce the volume and toxlGty of waste generat- <br /> ed to the degree I have determined to be etnnanicaly affordable and that I have selected the practicable method of treatment,storage,or disposal curraMy available to me <br /> which mfnimb=the present and future threat to human its and the environment:or,If I am a small quantity generator,I have made a Good faith effort to minimize my waste <br /> generation and select the waste managerrlent method that is available to me that I can afford, <br /> American Valley Waste Oil hereby advises the above Generator that gerorators shipment of used oil may be transported to a facility that is required to cornPlY with <br /> federffi <br /> reguletb m applicable to management of used oil,but that Is not required to comply with the more stringent requirements applicable to hazardoumanagement <br /> tiles.California facilities that handle or process used oil are required to meet those more stringent requirement,and some out-of-state s waste <br /> facilities that process used dl also meet <br /> those requirements,engineering certifications of tank integrity,and financial assurances for closure and accidental releases.It is laved fn send used n;i e„.h or e,ore i <br /> thnl l—PrY—Y wait ore <br /> fodl wmd all nnnagr:ment awwaiub alai not tllese more stringent requirements. raculeea <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 oon irmsfion for(certain waste streams)to the generator that thelr <br /> waste has been transported to a licensed treatment or transfer facility. <br /> DRIVER GENERATOR/ <br /> SIGNATURE: DATE i AUTHOR <br /> a�pL OSIGNAT DATE: <br /> d <br /> DISPOSAL/RECYCLING ING FA I ITY <br /> O DK-DIXON 1Y/ASBURY ENVIRONMENTAL RIVERBANK OIL TRANSFER 0 YUMA YES LLC O AMEgICAN VALLEY WASTE OR,INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD, 6500 US HWY 95 521 INDUSTRIAL DR STE M <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 <br /> 707-693-6006 209-541-1825 209.863-8181 928.344-9828 209.667-8857 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> '- MPC(7201fii <br /> -�';Rio i <br />