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550 W. Valpico Road, Tracy. Record ID PR0536554 <br /> 10/25/2017 <br /> PHOTO#3 <br /> Dis osal Record for drum <br /> — _ Amv-RICAN VkLLGY <br /> WASTE OIL, INC. <br /> P.0 Box 340•Delhi,CA 95315 <br /> PH, 1-800-732-4645•FAX 209-668-3880 <br /> C EPA# PLQQRgq1 <br /> /NCO RILL TO: JOB SITE <br /> R f;.Zo(7 <br /> Phone �Cuslonler P.O. Terms <br /> I_1�DC.A,R: i 1 <br /> PRODUCT SHIPPING DESCRIPTION WASTE <br /> — — I CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> i NON-RCRA Waste Liquid Used Antifreeze 133 <br /> U -- <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used Oil Filters <br /> I - - <br /> i <br /> TERMS Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal tees it court actiun TOTAL ,j <br /> becomes necessary to collect this invoice. <br /> By signing I herby certify That I have not mrsed.ny of the waste descnhed above with any other hazardous Y—ar.the form halide content is LESS than 1.000 ppm,a <br /> waste does not contain arty PCBs.I have con!Plant with the requirements of the appticahle Ca!ifnrnla used nil msnanerne.nt regulation to determine this is true.1 agl <br /> accept the additional chances for the disposal of this waste it the mtormation I haus Provdad about this waste Is Incorrect. <br /> Gerteretor's Oartilicauail:By signing I eerhly,that tl I am a large cl—li y generator.I certify that I hers a program in dace to reduce the.vnaarw and Insic!ty al%este <br /> ad to the degree I have detormined to be oconome:aay affordable and that I havo salacted the practicable method of treatment,storage.or disposal currently avail. <br /> which minimizes toe.presenl and future forest to human tile and the environment Or,it I am a small quantity clenefalm.I have nide a Good faith effort to minimize <br /> generation and select the wade management method that Is available to me that I ran afirnd. <br /> American Valley Waste Oil hereby adwses the above Generator that generafots shipment of used oil may be transported to a facility mala required to comply with <br /> regulations applicable to management of used oil,but that a cwt required to comply with the mote stringent requirements applicable to hazardous wast.--gem <br /> ties.California facilities that handle or prates.wed oil me required to meet those more stringent requiremenl.and some oul-cd-state f-11 les that process used oil, <br /> Inow requa6menls.enginoaring certitiaatkms of tank Integrity.and Financial assurancesfor closure and accidental releases.It re lawful to send used of to out al stir <br /> that Comply only with federal used dl management standards-d not time more stringent requirements. <br /> This notficatbn is ttlf lnfcrmitln only. <br /> By both parties elgnlnp Ihls In 11 wllF servr,ire an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the generator that Thee <br /> waste has been tralnlwdey a Gdended trenlment a Irensler Indhly. - - <br /> // GENERATOR( _ <br /> DRIVER r AUTHORIZED <br /> SIGNATURE / _. DATE"/' _7 ( 7-$IGNATURP <br /> DISPOS-A-LL RECYCLING FACILITY <br /> O DK-DIXON O ASBURV ENVIRONMENTAL Q RIVERBANK OIL TRANSFER O CFR-"-` C, <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.15TH ST It-"U N <br /> DIXON,CA 95620 CERES.CA 95358 RIVERBANK, CA95367 IA.CA 90021 STOCKTON.CA 95205 <br /> 707.693.6008 707.693-6008 209-863-8181 213.746,0237 818.770.2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190616 EPA#CAL000270577 EPA#CAL000417316 <br /> MPC t:'.nlul <br /> Betty Ho, EHS Page 3 of 3 <br />