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AMERICAN VALLEY 197050 <br /> WASTE OIL, INC. Invoice dumber: <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 ► FAX 209-588-3880 <br /> EPA# CAR000272302 <br /> BILL TO: JOB SITE: invoice Date: <br /> Phone Customer P.O. Terms EPA# a <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST OUANTITY PRICE _ AMOUNT <br /> CODE <br /> - i <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 1 <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 /> t <br /> TERMS: Invotoes over 30 Days are subject to a 1-5c%service charge. Customer agrees to pay all legal fees it court action TOTAL <br /> becomes necessary to collect this invoica. <br /> By signing I henry certify that I nave not mixed any of the waste described above with any other hazardous waste,the total halide oontent rs LESS then 1.GOO ppm,and the <br /> wastA does ndt contain any PCBs-I have complied wrth the requirements of the applicable Gaiitornia used oil management regulation to determine this rs true.I agree to <br /> accept the acidrtiorkw charges for the disposal of this waste if the Inftumation I have provided about this waste is incorrect. <br /> Generator's Ceirtsficatidn:By signing I certify that if I am a large quantity gertiQrator.i certify that 1 have a•program in place to reduce the volume and towcrty of waste generat- <br /> ed to the degree I have determined to be econornicaPy affordaole and that I have selected the practicable method of treatment,storage.or disposal currently avaiiabte to me <br /> which minimizes the present and future threat to human life and the environment:Or,rf I am a small quantity generator.I have made a Good faith effort to minimlXe rrty waste <br /> generation and select the waste management method that is available to me that I can afford. <br /> American Valley Waste Gil hereby advises the at�gve Generator that generators shipment of used oil may be transported to a tacilety 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 req urremertts applicable to hazardous waste management facili- <br /> ties,California facilities That Inartd[a 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 financral assurances for cidsure and accidental releases.It is lawful to sand used oft to out of state facilities <br /> that comply only with federal used ori management standards and not these.mi ore stringent requirements. <br /> This notification is for information purposes only. <br /> By both parties signing this Invoice it will serve as an agreement that Arizerican Valley Waste Oil will submit coafrrmation for(certain waste streams)to the generator that their <br /> waste has beery transported to a licensed treatment or transfer facility. <br /> GENERATOR' <br /> i <br /> DRIVER AUTHORIZED y s ' t I � . <br /> SIGNATURE DATE. _ SIGNATURE: DATE- <br /> DISPOSAL 1 RECYCLING FACILITY <br /> 0 DK-DIXON Q ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER YUMA YES LLC O AMERICAN VALLEY wASTE OIL INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD 5300 CLAUS RD- 6508 US HWY 95 521 INDUSTRIAL DR STE M <br /> DIXON,CA 96620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85385 LIVINGSTON.CA 95334 <br /> 707-693-6008 2097541-1825 209-863-8181 928-344-9828 209-667-8857 <br /> EPA#CAT08DO12602 EPA#CAL000393680 EPA#CALWO190816 EPA#AZRO00521146 EPA#CAL000443004 <br /> MPG(7r4i61 <br />