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AMERICAN VALLEY 1 ? $ WASTE OIL, INC. Invoice Number: P-O- Box 340 • Delhi, CA 95315 PH. 1-800-732-4645 • FAX 209-668-3680 EPA# CAR000272302 BILL TO: - ]OB SITE: Invoice Date: Phone Customer P.O. Terms FEPAII PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 I NON-RCRA Waste Liquid Used Oily Water 223 Compliant Drained Used Metal Oil Filters } TERMS: Invoices over 34 Days are subject to 4.1.5%service charge. Customer agrees-.(o pay an legal fees if court actin TOTAL becomes necessary to collect this invoice. 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 waste does not contain any PC6s.I have,conmiied wrth the requirements of the applicable Califomra used oil management regulation to determine this is true.I agree to accept the additional charges for the disposal of this waste if the Intormatfon I have provided about this waste is incorrect- Generator's Certification-By signing I rerrffy 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- ed to the degree I have determined to be economically affordable and that i have setected the practicable method of treatment,storage,or disposal currently available to me which minimaes the present and future threat to human life and the environmerrt:Or,if I am a small quantity generator.I have rnade a Good faith effort to minimize my waste generation and select the waste management method that:s available to me that I can aYfwd- Amer+can Valley Waste❑I hereby advises the above Generator that generators sttiptrtertt of used oil may be transported to a tacrlrty that is required to comply with federal reiguiations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facili- ties.Califomia rraciFtres that handle or process used oil are rygLiired to meet those more stringent requirement,and some out-of-state facilities that process used oil also meet 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 that comply only with federal used oil management standards and not these more stringent requirements. This notification is for information purposes orrly- By both parties signing Ehrs rrivoice rt wi11 serve as an agreement that Amenr an Valley Waste Oil will submit conf{rmaton for(certain waste streams)to the generator that their wasfe has been transp-grted to a licensed treatment or train Fair facility. GENERATQRI DRIVER AUTHORIZED SIGNATURE: . DATE. - SIGNATURE. DATE D15IQ.5AL_I RECYCLING FACILITY Q DK-DIXON 0 ASBUR Y ENVIRONMENTAL Q RIVERBANK OIL TRANSFER Q YUMA YES LLC a AMER[CAN VALLEY WASTE OIL.INC 7340 CHEVRON WAY 1920 MORGAN RE] 5300 CLAUS Ra. 6500 U5 HWY 95 521 INDUSTRIAL DP STE M DIXON,CA 95620 CERES.CA 95358 RIVERBANK. CA 95367 YUMA-AZ 85365 LIVINGSTON,CA 95334 7€77-693-6408 209.541-1825 209-863-8181 928-344-9828 209-667-8857 EPA#CAT 0800 12 602 EPA#CALOOD393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 MPC r7120161