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AMERICAN VALLEY <br /> WASTE n 1 <br /> NIL, INC. Invoice Number: <br /> P 0. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA#CAR000272302 <br /> BILL TO: AQSIMP ASN MSC <br /> JOB SITE: JR SI NPLOT - <br /> 18T77 HOV&ANQ ISD 18777 HOWLAND RD Invoice Date: <br /> LATHROP.CA 95330 LATHROP.C4 95$30 <br /> F <br /> arle ZO&$58.2511 Customer P.C. Terms EPA# <br /> Net30D>:yg CA0980814800 <br /> ODUCT SHIPPING DESCRIPTION <br /> WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 _ <br /> 4 c jalese <br /> NON-�iCRR Waste Liquid Used Antifreeze 133 O <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> OIL COLLEC11 ON FEE <br /> cm <br /> TERMS., Inva ices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action <br /> becomes necessary to collect this invoice. TOTAL ' <br /> By signing I herby certify that I have not mixed any of the waste describer)above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the 2�1 <br /> waste does not contain any PcE3s.I have complied with the requirements of the applicable California used oil management regulation to determine this is true,f agree to <br /> accept the additional charges for the disposal of this waste if the information I have provided about this waste is Incorrect- <br /> Generator's Certification:By signing I cartlfy 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- <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 I am a small quantity generator,i have made a G0001 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 he transported to a facility that is required to comply With federal <br /> regulations applicable t management of cess oil,but that re not required to comply with the more stringent requirements applicable to hazardous waste management facili- <br /> ties. require- encs,len that handle or process used all 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 serve as an agreement that American Valley Waste Oil will submit confirmation for(certain Waste streams)to the generator that their <br /> waste has been transported to a licenssd treatment or transfer facility. <br /> SIGNER GENER <br /> SIGNATURE: RIZED <br /> DATA.. SfCNADTil 9--�y <br /> dATE;� r <br /> DISPOSAL/ E Y L N F ILITY <br /> 0 DK-DIXQN Q ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER D YUMA YES LLC AMERICAN VALLEY WASTE OIL,INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. <br /> 7300 CCA 95fi20 CERES,CA 9N RD 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STE M <br /> 707-693-6008 209-863-8181RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON GA 95334 <br /> 209-541-1825 209^863-8181 <br /> EPA#CAT080012602 EPA#CAL000393690 928-344-9828 209-667-8857 <br /> EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443D04 <br /> MPC(-112016] <br /> 7 <br />