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AMERICAN VALLEY 186426 <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 /> EAST BAY CLARKLIFT-CHNI <br /> BILL TO: JOB SITE: --:AST BAY t'�ARi�LIFT Invoice Date: <br /> 4701 OAKPORT ST 1813 MOFFAT BLVD <br /> OAKLAND,CA 946014900 MANTECA,CA 95536 <br /> Phone 209-465-89-37 JENIFER Customer P.O. Terms EPA# <br /> G.O D CA 1.000394327 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> OIL COLLECTION FEE ,Op <br /> TERMS:Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if cowl action TOTAL , <br /> becomes necessary to collect this Invoice. <br /> By slgrirg 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 1.000 ppm,and the <br /> waste does not contain any FC89.I have compiled with the requirements of the applicable CaVornla used OR management regulation to deterndne this is true.I agree to <br /> accept the additional charges for the disposal of this waste It the information 1 have provided about this waste Is incorrect. <br /> Generator's CpNOcatiorr.By signing I ce"that rt I am a targe quantity generator,I certify that I have a program in place 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 mailable to me <br /> which minanizes the present and future threat to human fife and the environment:C if I am a small quantity generator,I have made a Good faith effort to minimize my waste <br /> generation and select the waste management method that is available to me that I can afford. <br /> American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility 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 faclll- <br /> ties.Cal fomra tacilidw that handle or process used oil are required to meet those more stringent requkanem.and some out-of-slate f=1111*s that proceea uaed oil also meat <br /> those requiremerds.engineering codifications of tank integrity.and financial assurances for closure and accidence!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 more stringent requirements. <br /> This notilicamon 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 confirmation for(certain waste streams)to the generator that their <br /> waste has been tra-ported to a licensed treatment or transfer facility. <br /> GENERA <br /> DRIVER <br /> SIGNATME, DATE;1�� SI TS REED <br /> DISP <br /> O DK-DIXON ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O YUMA YES LLC O AMERICAN Vuh.Er wnslE OIL INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM = <br /> DIXON,CA 95620 CERES.CA 95358 RIVERBANK, CA95367 YUMA,AZ85M5 LIVINGSTON.CA953M <br /> 707-693.6008 209-541-1825 209-863-6181 928-344-9828 209.667-8857 <br /> EPA#CAT080012602 EPA#CAL0o0393650 EPA#CALD00190816 EPA#AZROW521146 EPA#CAL000443004 <br /> MPC preoral <br />