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AMERICAN VALLEY 189355 <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: MANT€CA TIRL l <br /> 01 W:€DSON AVE JOB SITE: MANTECA TIRE Invoice Date: <br /> MANTECA,CA 95336 201 W.ED;ON AVE <br /> MANTECA,GA 55336 <br /> 4Wk CIL <br /> Phone Customer P.O. Terms <br /> Not3010lIys EPA&L0000102413 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON RCRA Waste Liquid Used Oil/Mixed Oils 221 6�r�144 <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 <br /> N �C <br /> TEAMS: Invoices over 30 Days are subject to a 1,5%service charge. Customer agrees to pay all Iegai fees if coEactio4nTO�T�AL11 r <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 1.000 ppm,and the <br /> waste does 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 <br /> accept the additional charges for the disposaf of this waste if 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 program in place to reduce the volume and toxicity of waste genamt- <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 minimizes the present and future threat to human life 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 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 ail may be transported to a facility that fs required to comply with federal <br /> regulations applicable to management of used oil,but that is not required to comply with the mwe stringent requirements applicable to hazardous waste management facili- <br /> 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 <br /> those 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 <br /> that comply only with federal used oil management standards and not these more stringent requirements. <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 confirmation for(certain sale treams)to the generator that their <br /> waste has been tra parted tof licensed treatment or transfer facility. <br /> DRIVER GENERATOR/ <br /> AUTHORIZED DATE. '� SIGNATUEDATE:'y'l d' <br /> DISP0 AL /-7 <br /> /RE Y LING FACILITY <br /> 0 DK-DIXON ASBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 YUMAYES LLC 0 AMERICAN VALLEY WASTE OIa,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 /> 707-693-6008 209-541-1825 209-863-8181 928-344-8828 209-667-8857 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC 020161 <br />