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AMERICAN VALLEY 39507 <br /> WASTE ®IL, INC. Invoice Number: <br /> I <br /> P.O.Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> (f Q EPA#CAL000827878 <br /> BIILTO 6� Yt chr� ctTt) i`e ;cif s 1;A Ir <br /> JOB SITE:G1h9q,AnX,\f6Re <br /> ) � � voice Date: <br /> ��r I <br /> PhoneCustomer P.O. Terms EPA# <br /> �', <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRIC '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 /> I <br /> 1 <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 J e <br /> becomes necessary to collect this invoice. F / <br /> By signing l herby certify that l have not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS fhan 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 d termine this is <br /> true.l agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect. I <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 anld 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, r disposal currently <br /> available to me which minimizes the present and future threat to human life and the environment:Or,if I am a small quantity generator,I have m de a 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 /> i <br /> By both parties signing this invoice it will serve as an agreement that American Valley waste Oil will submit confirmation for(certain waste stream )to the generator <br /> that their waste hash been,;ranspo4ed to a licensed treatment or transfer facility. <br /> f i...l-- GENERATOR/ <br /> DRIVER `//f, <br /> AUTHORIZED <br /> SIGNATURE: J: ��� jAl r ,% DATE: 12—'r f--� S NATURE """S DAT@ <br /> DISPOSAL/ RECYCLING FACILITY <br /> B 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 213-746-0237 810-787-2649 <br /> EPA#CAT080012602 EPA#CAL000270577 EPA#CAL 000379059 <br /> MPC(NMI a) <br />