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AMERICAN VALLEY 197301 <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: RIFILLA FARMS INC JOB SITE: RF=LLA FARM&INC- Invoice Date: <br /> 9261 5 WOLF RE) 92910 VVOLFE RD <br /> FRENCHCAMP,CA 95231 FRENCHCAMP.CA 96231 <br /> nolA <br /> Phone :09-471-4135 MARIO Customer P.O. Terms e� EPA CAL00041 GG83 <br /> PRODUCT SHIPPING DESCRIPTION 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 /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <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 TOTAL <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,uoo ppm,and the <br /> waste does not contain any PCBs.I have complied with the requirements of the applicable Callfornla used oil management regulation to determine this is true.I agree to <br /> accept the add Itional 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 Ile 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 all 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 notHicetlon 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 transport o a licensed tree ent or transfer facility, <br /> GENERATOR/ ` <br /> DRIVER AUTHORIZED� I <br /> SIGNATURE: DATE:3 2r �7 AUTH RIZE: DATE: �+ <br /> DISPOSAL/RECYCLING FACILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OILTRANSFER O YUMA YES LLC (!I—AMERICAN VALLEY WASTE OIL,INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RID. 6500 US HWY 95 521 INDUSTRIAL DR STEM <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 <br /> 707-693-60D8 209-541.1825 209-863-8181 928-344.9828 209-667-8857 <br /> EPA#CA7080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC V12016) <br />