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AMERICAN VALLEY 187193 <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 /> MANTECATIRE MANTECATIRE —� <br /> BILL TO: 201 W EDISON AVE JOB SITE: 201 W.EMSONAVE Invoice Date: <br /> MANTECA,CA 95336 MANTECA,CA 85388 <br /> 4WK.01 L <br /> Phone Customer P.O. Terms 6 B EPA9AL 0001024 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 wo 4 of <br /> 4 � <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 /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL (_y <br /> becomes necessary to collect this invoice. �L <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 disposal of this waste 4 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 vo;ume 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 am a sma31 quantlry 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 facill- <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 some as an agreement that American Valley Waste 011 wifl submit coniinnatlon for(cartel waste streams]to the generator that their <br /> waste has been transported to a icensed treatment of transfer facility. <br /> GENERATOR! <br /> DRIVER AUTHORIZED DATE <br /> SIGNATURE. DAT _ SIGNATURE: �1�� <br /> DISPOSAL/RE Y GFA LITY <br /> ASBURYENVIRONMENTAL O RIVERBANKOILTRANSFER OYUMAYESLLG 0AMERiCANVALLEYWASfEOIL,INC <br /> Q DK-DIXON 521 INDUSTRIAL DR STE M <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HVJY 95 LIVINGSTON,CA 95334 <br /> DIXON.CA 95620 CERES.CA 95356 RIVERBANK, CA 95367 YUMA,AZ 85365 209-667-8857 <br /> 707-693-6008 209-541-1825 209-863-8181 928-344-9828 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL00 443004 <br /> MPC(772016) <br />