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AMERICAN VALLEY 185171 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Bax 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4545 • FAX 209-658-3880 <br /> EPA##CAROID0272302 <br /> BILL TO: JR.SIMPLOT JOB SITE: JR SI MPLOT Invoice Date: <br /> AT.TN:RYAN MOCK 16777 HOWLAND RD <br /> 17 HOWLANDRD L-ATHROP,CA 95330 <br /> LA HROP.CA 95930 <br /> Phone X49-85$-2511 Customer P.O. Terms PPA# <br /> i,Jetaoisws I CAW80814800 <br /> PRODUCT SHIPPING DESCRIPTION I WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> Sp <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> O I L COLLECTION FEE <br /> TERMS: Involves 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 nw mixed any W the waste described above with any other hazardous waste,the total halide Cpntcmt Is LESS than 1,ni3o ppm,and the <br /> waste does not contain any PCBs.l have complied with the requirements of the applbcable Califomia used ail management regulation to determine this is true_I agree to <br /> accept the additio I charges for the disposal of this wasta if the infarrriation I have provided about this waste is incorrect. <br /> Generator's CenIficatiorn:by signing I certify that If t am a large quantity generator,l certify that I have a program In place to reduce the volume and toxicity of waste gerierat- <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 avallabwe 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 f can afford. <br /> American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may foe imnsported to a facility that is required to comply with federal <br /> regulattons applicable to management of used c11,but that is oat required to comply with the more stringent requirements appfioahfe to hazardous waste management faolli- <br /> ties.California facllitbsa 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 financW 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 requlrernents. <br /> This notification is for information purposes only. <br /> By bath parties signing this Invoice It will serve as an agreement that American Valley Waste Oil will submit confi7ro ion for(certain waste streamsy to the generator that their <br /> waste has b transp rted to a If ed treatment or transfer}acillly. <br /> GENERATOR/ <br /> DRIVER AUTHORIZE �. <br /> 51GNATURE J­rDAT w SIGNATU BATS <br /> DISPOSALI RE Y IN FAQILIT <br /> ❑ DK-DIXON FrASBURY ENVIRONMENTAL ❑ RIVERBANK OIL TRANSFER ❑ YUMA YES LLC D AMEFMANVALLEY WASTE OIL,IIVC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6504 US HWY 95 521 INDUSTRIAL DR STEM <br /> DIXON,CA 95620 CERES,CA 95358 RIVE=RBANK, CA 85367 YUMA,AZ 85365 LIVINGSTON,CASS334 <br /> 707-693-6008 2D9-541-1825 209-863-8181 928-344-9828 209.867-8857 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CALa00190816 EPA#AZR000521146 EPA#CALA00443004 <br /> MPC(7MOIS) <br />