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R EC E i VED AMERICAN WLLEY <br /> WASTE OIL, 114C. Invoice Number: <br /> APR 15 2014 P.0, Bax 340 - Delhi, C% 95315 <br /> PH. 1-800-732-4645 * FAX ',109-668-3880 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT EPA# CAL00082-,878 <br /> BILI,TO: JOB SITE Invoice Date: <br /> VVA'rE R CW'' 4,Lr -4 <br /> 0 <br /> "'A <br /> Phone customer P.O. <br /> 'Terr I& <br /> PROBUM-FVIPP IR DE fiRtIPTION WASTE N AN I FESt' QUANTITY PF(1)6I=' M—CrUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze I 133 <br /> NON-RCRA Waste Liquid Used Oily Water <br /> 223 <br /> Drained Used Oil Filters <br /> L <br /> 7 <br /> -4— <br /> < <br /> I , <br /> .......... <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees,tc pay-alt legal fees it court action <br /> TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify that I have not mixed any Df the waste described above with any othE-hazardous waste,the total halide content is LESS than C 1 ppK <br /> and the waste does not contain any PCBs.I have complied with the requirements of the applicz tile California used oil management regulation to determi il',L-7 <br /> true.I agree to accept the additional charges for the disposal of this waste if the information I Ir ave provided about this waste is incorrect. <br /> Generator's Certification:By signing!certify that if I am a large quantity generator,I certify tha 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 selec ed the practicable method of treatment,storage,or disposal currently <br /> available to me which minimizes the present and tuture threat to human life and the environnnmt-Or,if I am 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 avail able to me that I can afford. <br /> By both parties signing this invoice it will serve as an agreement that American Valley Waste of will submit confirmation for Icertain waste streams)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> GENERAIC 11 <br /> DRIVER -4 AUTHORIZE D <br /> 7- ) <br /> SIGNATURE: DATE: SIGNATUIF E: DATE., <br /> DisposAL I RECYCLING FACILITY <br /> 0 DK-D)X,"ON C; CFR 0 UNITED ENTERPRISES CORP in, <br /> 7300 CHEVRON WAY 2035 E. 15TH ST. 11100 PENROSE ST. r -yam <br /> DIXON,CA 95620 LA CA 90021 SUN VALLEY,CA 91352 • <br /> 707-693-6008 213-746-0237 815.787-2649 <br /> EPAA CAT080012602 EPA#CAL000270577 EPA#CAL000379059 <br />