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AMERICAN VALLEY 120040 <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 /> 2-a�=21 <br /> BILL TO: RIELLA FARM5ING. JOB SITE: RIELLA FARMS INIC. Invoice Date: <br /> 9261 S WOLFE K) 9251 S WOLFE RD <br /> FRENCH CAMP.CA 95231 FRENCH CAMP,CA 95231 <br /> Phone 209 471-4135 MARIO Customer P.O. Terms 40 D tPA10093 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUCE AMOUNT ; <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters , -pp -70, <br /> OIL COLLECTION FEE <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action I TOTAL —7 O <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 totat halide content is LESS than 1,000 ppm,and the <br /> waste does not contain any PC13s.I have compiled 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 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,It 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 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 stale facilftfes <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 licensed treatment or transfer facility. <br /> GENERATOR! *`— <br /> DRIVER AUTHORIZED <br /> SIGNATURE: __/ DATE: 2— —�( SIGNATURE: y— ATE: —2 —Z <br /> DISPOSAL/RECYCLING FACILITY ��// <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O YUMAYES LLC l�521 INDUSTRIAL <br /> STRI L DRSTE OILI <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM <br /> DIXON,CA 95620 CERES,CA 95356 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 <br /> 707-693-6008 209-541-1825 209.863-8181 928-344-9828 209-667-8857 <br /> EPA•#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC 171Pe161 <br />