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AMERICAN VALLEY 190039 <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 /> MUM RIELLA FARMS INC. JOB SITE: RIELLA FARMS INC. Invoice Date: <br /> 9261 S WOLFE RD 9251 S WOLFE RD <br /> FRENCH CAMP,CA 95231 FRENCH CAMP,CA 95231 <br /> Phone Mpg 471 4135 MARIO Customer P.O. Terms EPA" <br /> C.O.D. CALOQU410Q93 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTfTY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 S JJ c C <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 PEE QS-ob <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees it court action TOTAL .Z .3 <br /> becomes necessary to collect this invoice. <br /> 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 1,0r 0.I agree <br /> and the <br /> waste does not contain any PCBs. have compiled with the requirements of the applicable California used oil management regulation to determine this is true. 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 certify 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 Good faith effort to minimize my waste <br /> generation and select the waste management method that is available to me that I can afford. <br /> American Valley Waste Oil 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 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 A will serve as an agreement that American Valley Waste Oil will submit confirmation for tcertain waste streams)to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ ~ �� <br /> AUTHORIZED <br /> pRIVER f I ATE:' <br /> SIGNATURE: DATE: �,g IGNATURE: <br /> DISPOSAL/RECYCLING FACILITY <br /> Q DK-DIXON aASBURY ENVIRONMENTAL O RIVERBANK OILTRANSFER O YUMA YES LLC O AMERICAN vALFY WASTE OIL.INC <br /> 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM <br /> 7300 CHEVRON WAY 1920 MORGAN RD. LIVINGSTON,CA95334 <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 209-667-8857 <br /> 707-693.6008 209-541-1825 209-8fi3-8181 928-344-9828 <br /> EPA#CAT080012662 EPA#CAL000393680 <br /> EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC(7/2016) <br />