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BILL TO: <br />• AMERICAN VALLEY 124436 <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# CAL000827878 G f <br />JOB SITE: J In oice Date: <br />MOE AUTO R EPAIR MOE AUTO REPAIR <br />2265S. AIRPORT WAY 2255 S. AIRPORT WAY <br />STOCKTON. CA 95206 STOCKTON, CA 95206 <br />PhoN_q�_ I � D <br />:r� <br />Customer P.O. <br />Terms <br />EPAt _ I OX31 _ IUB I <br />J� <br />PRO CRIPTION <br />OPAST <br />QUANTITYWPR <br />AMOUNT <br />WASTE <br />CODE <br />-NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />63-70WL&E <br />ZS <br />!1r 25 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Drained Used Oil Filters <br />i <br />r <br />TERMS: Invoices over a0 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 />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, <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 />Generators 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 oil 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 />GENERATOR/ <br />DRIVER j[/ / DATE: <br />DATE ATURE: <br />SIGNATOR / SIGNATURE: <br />DI POSAL /RECYCLING FACILITY <br />DK-DIXON O CFR O 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# CALOOD379059 <br />