Laserfiche WebLink
AMERICAN VALLEY +-3?:; -`a <br /> WASTE OIL, INC. Invoice [dumber: <br /> P. O. Bax 340 • Delhi, CA 95315 <br /> PH 1-800-732-4645 a FAX 209.668-3880 <br /> EPA#CALOOOB27878 <br /> ,.L TO: JOB4r In/voice Date: <br /> JJv h)rC <br /> none Customer P.O. Terms EPA# <br /> �yy�_royc� e o L-000 3"/ r <br /> 'RODUCT SHIPPING DESCRIPTION WASTE MANIFEST JQUANTITY PRICE AMOUNT <br /> CODE <br /> JON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> VON-RCRA Waste Liquid Used Antifreeze 133 <br /> VON-RCRA Waste Liquid Used Oily Water 223 <br /> gained Used Oil Filters <br /> PERM[ SERVICFS <br /> FRMS: Invoices over30 Days are subject to a 1.5%service charge. Customer agrees to pay ad]legal fees if court action ,TOTAL <br /> ecomes 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 LE5S than 1,000 ppm, <br /> and the waste does no-contain am,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:3y 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 dispos;tt currently <br /> available to me which minimizes the present and future threat to ht men I fe and the environment:Or,if I am a small quanfrty generator,I have made a good faith <br /> effort to minimize my waste generation and select the waste management method that is available to methat I an afford. <br /> By bath 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 /> SIGNDRIVATOR !/� DATE: JJ —ASIGNATZEO ff <br /> i/ SIGNATURE' •KK"��� <br /> DISPOSAL / RECYCLING FACILITY <br /> DK-DIXON O CFR O UNITED ENTERPRISES CORP <br /> 7300 CHEVRON WAY 2035 E.15TH ST. 11190 PENROSE 5T. <br /> DIXON,CA 95620 LA,CA 90021 SUN VALLEY,CA 91352 <br /> 707.693-6008 213-746-0237 - 818-787-2649 1 <br /> EPA#CATOBOD126M EPA4 CAL000270577 EPA#OAL000379059 <br /> Pips far2a1m <br /> q d d2Z:t:O'L L 17 l AON <br />