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AMERICAN VAURL EIVEL 133391 <br /> WASTE OIL, INC. 'v Invoice Number: <br /> P. O. Box 340 • Delhi, CA 95315 APR 2 4 2015 <br /> PH. 1-800-732-4645 • FAX 209-6 <br /> EPA# CAL000827878 6-N <br /> bRONMENTTyrp *u-FOlATgACATT �r � 5_ <br /> BILL TO: JIM THORPE OIL INC JOB SITE: NANCY N&UYEN' <br /> Is O.BOX 357 4445 PERSHING Invoice Date: <br /> LODI, CA 95241 STOCKTON, CA 95205 <br /> CAC002807233 <br /> Sales Rep Steve <br /> Phone Customer P.O. Terms EPA# W y0 �Z <br /> 209-462-4581 Net 30 Days 4�tf't'8 ` <br /> PRODUCT SHIPPING DESCRIPTION WASTE ' MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> .1: <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 � <br /> NON-RCRA Waste Liquid Used,Antifreeze 133 <br /> NON-RCRA Waste Liquid Used iQlly Water , 1 <br /> Drained Used Oil Filters <br /> 7 c�f / r -nI— <br /> DUE TO THE DRASTIC FALL IN CRUDE OIL <br /> PRICES,WE HAVE BEEN FORCED TO <br /> CHANG <br /> FILTER PICKUP, <br /> Sales Tax <br /> TERMS: Invoices over 30 Days are/subject to a 1..5%service charge. Customer agrees to pay alllegal fees if court action TOTAL <br /> becomes ii 11 collect thiss""invoice. <br /> By signing I herbycertify 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 compliedwith the.requirements of the applicable.6alifornia usedoil management regulation to determine thisis <br /> true-I agree to accep[the additional charges for thedisposalof 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 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 di�fosal currently <br /> available to me which minimizes the present and future threat to human life and the environment:Or,if I am a small quantitygenerator,.l have made 3 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 toa.licensed treatment or transfer facility. <br /> GENERATOR/ <br /> DRIVER `AUTHORIZED _ <br /> SIGNATURE: DATE "SIGNATURE: DATE{. -.3 <br /> DISP AL / RECYCLING FACILITY <br /> <-k-DIXON O CFR O UNITED ENTERPRISES CORP 1 <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 />