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AMERICAN.VALLEY 4r� r7P <br /> WASTE 01L I N c Invoice Number: <br /> -P.O. Box 340 • Delhi, CA 95315 <br /> PH 1-800-732-4645 • FAX 209-668-3880 <br /> EPA# CAR000272302 <br /> 4 <br /> y 4 sP+' <br /> BILL To. ,. <br /> ' ' a, a- . • <br /> • JOB SITE: Invoice Date. <br /> `. Y _ S:-F <br /> y <br /> Phone Customer P.O. Terms EPA# _ <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST QUANTITY PRICE AMOUNT <br /> WASTE <br /> CODE <br /> NON RCRA W 'd Used Oil/Mix it 221 <br /> Was Li uI Oil/Mixed Oils � <br /> f <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NOWRCRA Waste Liquid Used Oily Water 223 <br /> N' Compliant Drained Used Metal Oil Filters <br /> F <br /> L <br /> oLO <br /> CD <br /> s <br /> rr <br /> N <br /> Z }} <br /> Z <br /> I _ <br /> r <br /> W G <br /> C'3 <br /> LLI <br /> TERMS: Invoices over 30 Days are subject to a 1.50/6 service charge. Customer agrees to pay all legal fees if court action <br /> TOTAL <br /> ,becomes necessary to collect this invoice. <br /> 4. <br /> B signing l herb <br /> certi;.that I have not mixed an of the waste described above wit ' <br /> y.,J g y fy y i h any other hazardous waste,the total halide content is LESS than.`1,000 ppm,and the <br /> vast this, ,. <br /> e does not contain any PCBs.I have complied with the requirements of he applicable California used oil management regulation to determine this is true.I a ree to <br /> 9 9 g <br /> t accept the additional charges for the disposal of this waste if the information I have provided about this waste is'`inc.orrect. <br /> P <br /> Generators e C rtification:By signing I certify that if I am a large,quantity generator,l 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 /> 1 <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 <br /> y to management of used oil,but that is not required to compl with.the more stringent requ.1 irements applicable to hazardous waste man'ag ement 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 /> I <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 /> y <br /> r'> GENERATOR/' , <br /> -DRIVER ' {y AUTHORIZED <br /> F :z "k <br /> r <br /> f a <br /> n <br /> SIGNATURE '�: DATE: <br /> -;i� .,. . ����� DATE: <br /> I <br /> � DISPOSAL/_RECYC., ING FACILITY <br /> O DK-DIXON ASBURY ENVIRONMENTAL RIVERBANK OIL TRANSFER YU.MA YES''LLC AMERICAN VALLEY <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 WASTE OIL, INC. <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK,' CA 95367 YUMA,AZ 85365 9767.4TH ST.#B <br /> 707-693-6008 209-541-1825 209-863-8181 928-344-9828 D E LH I,CA 95315 <br />► EPA#CAT080012602 EPA#CAL000393680 EPA#CAL0001190816 EPA#A7131000521146 209-667-8857 <br /> EPA#CAL000469438 <br /> L <br />