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AMERICAN VALLEY 183177 <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 /> BILL TO: JR,SIMPLOT ]OB SITE: & °2 <br /> ATT N: RYAN MOCK 3R sl full'LOT Invoice Date: <br /> 15777 HOVVLANDR€] 16777HO%VLAND RD <br /> LATHROP,CA 95330 LATHROP,CA 95330 <br /> FPRODUCT <br /> 2179-658-2�a11 Customer P.O. Terms <br /> EPA# <br /> Net 30 Days CAD980814800 <br /> SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> ! b fL< _ �- <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 /> OIL COLLECTION FEE <br /> EEETEt4c?stp <br /> TERMS: Invoices over 30 Days aro subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL becomes necessary to collect this invoice. <br /> 51 <br /> By signing I herby certify that 1 have Trot 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 if the inforn aticn I have provided about this waste is incorrect, <br /> Generator's Certification: to signing I certify that if!am a large quantity generator,I certify that 1 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 1 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 availahie to me that I can afford, <br /> American Valley Waste dif 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 facili- <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 Gosure 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 serve as an agreement that American Valley Waste Oil will submit con at' <br /> waste has been transported to a licensed treatment or transfer facillty, in waste streams)to the generator that their <br /> R <br /> DRIVER GENERATOFU <br /> SIGNATURE: AUTHORIZED <br /> DATE: i✓ Q7NATURE: DATE• 4 <br /> DI P AL 1 RECYCXING FACILITY <br /> 0 DK-DIXON JS ASBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 YUMA YES LLC �AMERICAN VALLEY WASTE OIL INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. <br /> DIXON,CA 85$20 CERES,CA 95358 RIVERBANK, CA 95367 Y MA,AZ 5365 L 6500 US HWY 95 IVING INDUSTRIAL <br /> CA5334TE M <br /> 707-693-6008 208-541-1825 209.863-8181 <br /> 928-344-9628 209-667857 <br /> EPA#CAT080012602 EPA#CAL000393680 <br /> EPA#CAL00019081& EPA#AZRD00521146 EPA#CAL00D943004 <br /> •- MPC(71207 8] <br /> a ■ � <br />