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AMERICAN VALL FCEJVEL 132891 <br /> WASTE OIL, INC. JUN 2 4 2015 Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-66 IRONMENTAL/�/ L <br /> EPA#CAL000827878 C,ITIJr�CD�OTttCA1T /��� <br /> ACME SAW ACM SAW J <br /> BILL TO: 1204 E.MAIN JOB SITE: 214 N SACRAMENTO ST In nice Date: <br /> 'TOCKTON, 95206 LODI, CA 95,240 <br /> Sales Rep Albert Ketting <br /> Phone209-948.6735 DIANA ustorner P.O. Ternisi 30 DI EPA#CAL000316056 <br /> PRODUCT SHIPPING DESCRIP 1 ION WASTE MANIFEST. QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> I <br /> i <br /> DUE TO THE DRASTIC FALL IN CRUDEOIL <br /> PRICES.WE HAVE BEEN FORCED TO <br /> CFIA61GE PRICING FOR WASTE OIL AND � <br /> I <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL <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 vi aste,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 prog ram 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 practi able 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 a 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 thl h t I can afford. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste Oil will submit c nflrmation for(certain waste streams)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> //y� r GENERATOR/ <br /> DRIVER ' �'� / /i`�_AUTHORIZED <br /> SIGNATURE: -1 / �✓ DATE. -��- ! -1 SIGNATURE: _ - _�- DATE: <br /> I <br /> ISPOSAL/ RECYCLING(FACILITY <br /> DK-DIXON O CFR 11I 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#CAL000379059 <br /> MPC(6/2013) <br />