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BILL TO: <br />AMERICAN VALLEY <br />WASTE OIL, INC. <br />P.O. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 • FAX 209-668-3880 <br />EPA# CAR000272302 <br />JOB SITE: <br />24 11. 471 <br />Invoice Number: <br />Invoice Date: <br />Phone <br />Customer P.O. <br />Terms <br />EPA# <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Compliant Drained Used Metal Oil Filters <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. Customer agrees to pay all legal fees if court action <br />becomes necessary to collect this invoice. <br />TOTAL <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 1,000 ppm, and the <br />waste does not contain any PCBs. I have complied 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, 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 it will serve as an agr«,c!rnent 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: SIGNATURE: DATE: <br />DISPOSAL/ RECYCLING FACILITY <br />O DK-DIXON U ASfiURY ENVIRONMENTAL U RIVERBANK OIL TRANSFER O YUMAYES, LLC Q AMERICAN VALLEY <br />7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 WASTE OIL, INC. <br />DIXON, CA 9562.0 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 DELHI, CA 95315 <br />EPA# CAT080012602 EPA# CAL000393680 EPA# CAL000190816 EPA# AZR000521146 209-667-8857 <br />EPA# CAL000469438 <br />