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AMERICAN VALLEY 190916 <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 /> r <br /> BILL TO: MANTECA TIRE JOB SITE: MANTECA TIRE Invoice Date: <br /> 201 W.EDISON AVE ZQ1 W.ECiSONAVE <br /> MANTECA,GA 95336 MANTECA,CA 95336 <br /> 4WK OIL <br /> Phone 209-239-3558 GREG Customer P.O. Terms EPA# <br /> Net 30 Days CAL000010248 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 a 1 7 ''�CJ 1� .35 6A% <br /> 50 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 )) `1 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> OIL COLLECTION FEE <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect 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 1,000 ppm,and the <br /> waste does not contain any PGBs.I have compiled with the requirements of the applicable California used oil management regulation to determine this is true.f agree to <br /> accept the additional charges for the disposal of this waste if the information I have pmvided atwut this waste is incorrect. <br /> Generator's Certtication: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 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 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 oil may be transported to a facility that is required to compty with federal <br /> regulations applicable to management of used oil,but that is not required to comply with the mom stringent requirements applicable to hazardous waste management facili- <br /> ties.California facilities that handle or process used oil aro 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 all 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 waste streams)to the generator that their <br /> waste has bean transported t a licensed treatment or transfer facility, <br /> GENERATORI <br /> DRIVER C AUTHORIZED <br /> SIGNATUR DATE: SIGNATURE: h DATE4,,j �� <br /> DISPOSAL/RE YC INC FACILITY <br /> O DK-DIXON ASBUAY ENVIRONMENTAL O RIVERBANK OIL TRANSFER YUMA YES LLC Q AMERICAN VALLEY WASTE OIL,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#CALOOD393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443OG4 <br /> MPC(712016) <br />