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AMERICAN VALLEY <br /> WASTE ®ILS INC. Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA#CAL000827878 <br /> NICSAUTO <br /> DOMENICSAUTO 40305 NEHARRISON ST. If Ile <br /> dI .L T 935 N. HARRISON ST. JOB SITE: STOCKTON, CA 95203 Invoice Date: <br /> STOCKTON, CA 95203 <br /> / ci3 Y.:FREMONT <br /> V% 1 L Sales Rep. Albert Keltinq <br /> Phone209-943-1040RCBERT Customer P.O. jTer¢Ip,D. EPAOCALOOD234978 <br /> i <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST OUANTITY PRICE AMOUNT <br /> CODE <br /> NOM-RCRA Waste Liquid Used Oil/Mixed Oils 221 55 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NOAI-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Fitters <br /> I I <br /> I <br /> i <br /> CE11.At 19 FI 6:17 Fill I, I w F <br /> PRICES,WE HAVE BEEN FORCED TOCHA 1GE '.. R <br /> GPI6 NPBT� <br /> DEC �1 O fl1 <br /> EWIRONMENTA <br /> /SFP!, rt c <br /> ERMS. Invoices over 30 Days are spojem to a 1.5%service charge. Customer agrees to pay all legal lees u court action TOTAL t <br /> be-comes necessary to collect this invoice. 1, - -r_ <br /> ey signing 1 herby cernry that t have not mixed any of the waste described above with any other hazardous waste,the total aalide content is LESS than 1,000 ppm, <br /> and the waste does rot coctain any PCBs.I have complied wit)the requirements of t,a applicable Califomia used oil management regulation to determine this is <br /> true,i agree to adept the additional charges for the disposal of this'xaste if the informaton 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 pace to recuce the volume and toxicity of waste <br /> generated to the degree 1 have determined to be economically affordable and that I have selected the practical-e method of treatment.storage,or disposal currently <br /> avaifable to me which min.1i the present and future threat to human life and the environment:Or,if I ar•.a small quantity generator,I have made a good faith <br /> effort to minimae my waste generation and select the waste management method that u available tome that i Can afford. <br /> &/bott parties�igning invoice it will serve as an agreement that Ama_ricar.Valley Was:e Oil will submit confirmation for(certain waste stream. j to the generator <br /> that their a•astehas be anspoted to a licensed treatment or transfer facility. <br /> f � / <br /> ` GENERATOFIJ <br /> DRIVER -r-- / AUTHORIZED <br /> 9GNATURP >fV DATE: ' — (� U SIGNp.TURE: DATE: f., .fW1 <br /> DISPOSAL/ RECYCLING FACILITY <br /> DK-DIXON O CFR O UNITED ENTERPRISES CORP i <br /> 73OD CHEVRON WAY 2035 E-15TH ST. 1 1190 PENROSE ST. <br /> DIXON. CA 95620 LA,OA 90021 SUN VALLEY,CA 91352 <br /> 707-693-6008 213-746-0237 818-787-2649 <br /> EPA9 CATO800:2602 EPA+CALOD0270577 EPA#CAL000379059 <br /> l <br /> i <br /> Mre wets; <br /> 9'd d0£ £0'L 1, t?l, ADN <br />