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I <br /> WASTE OIL, INC. Invoice Number., <br /> P.O. Box 340 • Delhi, CA 5315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA# CAR000272302 <br /> BILL TO: JOB SITE: jllYUiCe Date; <br /> F'ilorse 1}slomer RID, Terms EPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE I MANIFEST 4UANTITY PRICE AMOUNT <br /> CODE <br /> NON-RC RA Waste Ligvid Used O'il/Mixl~d Oils 221 <br /> NON-FIC RA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> TERMS: Invoices over 30 Days are subject to a 5-5%service cnerge customer agrees to pay all legal fees d courl aclton TOTAL i <br /> becGrnes necessary to collect thie Invoice. <br /> By eitgning I NdUy"Wry trial 1 havo trot mixed Bny of IN waStrr dascnbed above with any ether hivardnu, wastu.the tetil halide centaur is LESS itien 1 000 ppm,and the <br /> waste dogs not oorrLwn any PCBs_I have evmphed with the rmulrenwis of the wplicagle Calllorn,p used opt managomenl requiawn to(teterrrune Irus is true.I agree to <br /> acx,-ap[the addi[iarlat charges for the dispose!of 1hls wesle it the Inforrnallon I trove Wowldrd about Ibis wasto is incorrect, <br /> Gonorato+'S Canitienon,SY signing I oadily that d f am a I:uUa quatl[i y generator,I certify ifial I have a program in plan:a to reduce itie vdume and iaxicity or waste gel,erat- <br /> od to Ito degrm 1 hriyR dotormined to bR aLonoYr kWry aRcrdebie and Ihet I have setecied the precticaue method of ueatment-slora,ge-or dispasai cvrrtnuy evailiae to In& i <br /> vi,irls snihirnims 1110 pee&eIll rlrr{I lsiluro threat to Kumar}Ro and the unwunment:Q(,'rf I am a small 4iuertiity gwieralor,I haze mode a GDod faith effort is minimize my waste <br /> generation area solect via wamo rnan@a Ierrrpnd moviou Mat is available to me dial I can afford. <br /> Amerman VaJIgy Waste pit heMby edvisn the pwve Gertevor thgt g9herivofS shipment of used ou may 4e transported to it fggilily thai is r9gwrea 10 comply with ledorai <br /> reg[dptipns lipPlicdt]la to rr►on,r,Jms e l 01 uaefi oil.put that IS not hXruirod to Comply with I"mom siririg&nt requlror► fits applicaule to hanrdovs waste maf+avm0eit incili- <br /> Ims.California facdilies Ihai handle cr process used cd1 era required to meal thane mote stringent requirement,and soma out-ar-state faeililies 1he1 promss used oil alsp rreeet <br /> thiMe ro0uirffiTPW[9,e+lgrneering corliiications o1 tank integrity,and financial assurances for closure and amidental releases.It Es lawful to send used oil ro out of elate faedities <br /> !hat comply only wilh federal used ad management smnderds and not These mare stringent requiremenis- <br /> T hks notificatign IS frsr Inlgtms}iion purW!586 on y. <br /> Sy both perims signing Ibis mvo;oe it will serve as an agreement 1he1 American Valley Waste ICI will submit earrlicmalion far fcertgin w stestrearnQ to the generator That it,elr <br /> waste has been lranspDrted In a licensed 1rommenl or lranster Iacility. <br /> GENERATOW <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE- SfGNATLIHE' DATE: <br /> Q IS POSAL 1 RE YC LI NG FA ILITY <br /> DK,DIXC)N ASSORY ENVIRONmr:; 17AL 0 RIVERBANK OIL TPA14SFER 0 YUMA YES LLO AMERICAN VALLEY <br /> 7"CHEVRON WAY 192(1140RGAN RD. 53W OLAUS RD- 6500 us HWY 95 WASTE Oil, INC.. <br /> DIXON.CA 956 CERES,CA 1}5358 lgIVERSANK OA95367 YUMA,AZ 05365 9767 4TH ST 9U <br /> 707-693-60W 209-541-1625 209-M-8181 928-344-9828 DELHI, CA95315 <br /> EPA+CATOB0012602 EPA#CAL000393680 EPA#CAZOD0190816 EPA#AZRWO52114$ 209-667-8857 <br /> EPA#CALO00469436 <br />