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AMERICAN VAL ' . V d VE <br />WASTE OIL, INC. APR 13 2015 Invoice Number: <br />P. O. Box 340 • Delhi, CA 95315 <br />PH. 1-800-732-4645 •FAX 209-6�`�'iR�NMENTAp, <br />EPA# CAL000827878 tic rT nr n <br />LOVES TRAVEL STOPS "' �TAAC�IT / <br />ILL TO: ATTENTION: MICHAEL KEY JOB SI'I'E: LOVE'S TRAVEL STOPS <br />10601 NORTH PENNSYLVANIA 1553 COLONY RD Invoice Date: <br />OKLAHOMA CITY, OK 73126 RIPON, CA 95366 <br />Sales Rep <br />Phone40 _751-9000CHRIS Customer PO <br />�TermsNet30Days EPA#CAR000220707 <br />I <br />PRODUCT SHIPPING DESCRIPTIONWASTE <br />I MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />CODE <br />221 <br />133 <br />NON•RCRA Waste Liquid Used OiVMixed Oils <br />NON-RCRA Waste Liquid Used Antifreeze <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Drained Used Oil Filters <br />TERMS: Invoices over 30 Days ate suhiecf to a 1.5�o service charge. Customer agrees to pay all legal fees if court action <br />becomes necessary to collect this nvoice. <br />TOTAL <br />By signing I herby certify that I have riot mixed any of the waste described above with any other hazardous waste, the total halide content is LESS than 1,000 ppm, <br />and the waste does not contain any PCBs I have complied with the requirements of the applicable California used oil management regulation to determine this is <br />true. I agree to 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 <br />generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment, storage, or disposal currently <br />available to me 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 <br />effort to minimize my waste generation and select the waste management method that is available to me that I can afford. <br />By both parties signing this invoice it will serve as an agreement that American Valley Waste Ori will submit confirmation for (certain waste streams) to the generator <br />that their waste has been transported to a licensed treatment or transfer facility <br />n <br />G NERATOK <br />% <br />D GNA URE: -- / ---- ._ . ---- — DATE: L v – / ! 1 S GNATURE DATE- <br />ATEDISPOSAL <br />DISPOSAL/ <br />/ RECYCLING FACILITY <br />0 DK-DIXON O CFR U UNITED ENTERPRISES CORP <br />+! 7300 CHEVRON WAY 2035 E. 15TH ST_ 11190 PENROSE ST. <br />DIXON. CA 95620 LA, CA 90021 SUN VALLEY, CA 91352 <br />707-693-6008 213-746-0237 818-787-2649 <br />EPA# CAT080012602 EPA# CAL000270577 EPA# CAL0003-19059 <br />i <br />MPC f151;2G131 <br />