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*AMERICAN VALLEE�VE[ 122321 <br /> WASTE OIL, INC. voice Number: <br /> P. O. Box 340 • Delhi, CA 95315 JUN 2 4 2015 <br /> f PH. 1-800-732-4645 • FAx 209-668- WIRONMENTAL <br /> l EPA#CAL000827878 uCQ1T�r\C010TAAC6IT >, Jt_/ <br /> BILL TO: ACMJOB SITE: ACME W In bice Date: <br /> ACME SAW E.MAIN 214 N. CRAMENTO ST. <br /> LODI, 95240 <br /> STOCKiON,CA 95 I <br /> Phone ustomer P.O. Terms E A# <br /> i <br /> �) c 1 r. Net :50 Days f a 1 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 5100 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> CAI Pc� T AV <br /> TERMS: Invoices over 30 Days are subject to a 1.5%o service charge. Customer agrees to pay all lega fees if court action TOTAL <br /> becomes necessary <br /> 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 Lste,the total halide content is LFSS than 1,000 ppm, <br /> and the wastedoes 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 accepptthe additional charges for the disposal of this waste if the information I have provided about this waste is incorrect. <br /> i <br /> Generator's certification:By signing I certify that if I am a large quantity generator,I certify that I have a prof ram in place to reduce the volume and tonicity of waste <br /> generated to the degree I have determined o be economically affordable and that I have selected the practi able method of treatment,storage,or disposal currently <br /> available to me which minimizes the presen and future threat to human life and the environment:Or,if I an 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 tome th it I can afford. <br /> By both parties signing this invoice it will sei ve as an agreement that American Valley Waste Oil will submit nfirmation for(certain waste streams)to the generator <br /> that their waste has been transported to a I' ensed treatment or transfer facility. <br /> n <br /> i( GENERATOR/ <br /> / f� AUTHORIZED <br /> DRIVER . .t,,.... � �f -yf�` DATE: -.:i f_' /G� I/ DATE: <br /> SIGNATUR : / -SIGNATURE: <br /> I 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 213446-0237 818-787-2649 <br /> EPA#CAT080012602 EPA#I CAL000270577 EPA#CAL000379059 <br /> MPC(62013) <br />