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AMERICAN VALLEY � 140589 <br /> WASTE OIL, INC. Invoice Number: J <br /> P. O. Box 340 a Delhi, CA 95315 / <br /> PH. 1-800-732-4645 ^ FAX 209-668-3880 <br /> EPA# CAL000827878 <br /> SILL TO: JOE SITE: <br /> 4971 itvDUSTR{AL 11u1Y S'u'K70;,s, -,A 95: d Invoice Date: <br /> TRACY,CA.. 95304 SAA OIL <br /> .9a;1 RW. <br /> Phone Customer P.O. I Ter frl� , EPA# <br /> PRODUCT SHIPPING DESCRIPTION I 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 /> ! 5 <br /> i�u=-`C '" - :-s1Si'iw'>=AL?iRItU,"•2UDE_::': <br /> PRICING FOR WASTE C7N.A )RILT!-ERK Uf <br /> .ta in Tax <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 waste,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 th a 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 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 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 made 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 /> 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 to a licensed treatment or transfer facility. <br /> ~`^ _ GENERATOR/ <br /> DFtl1"Ep •% 7�. AUTHORIZED ,r1 !`�,�, ; 1 ... %"�,•- '(' <br /> /, J <br /> �. <br /> ,SIGNATURE: f;�- -� 7, DATE:r�,y'/,'jam, '/�SIGNATURE: , � <br /> 01SFOSALI EE=•YULING FACILITY <br /> O DK-DIXON_ .. ®`EER O UNITED ENTERPRISES CORP <br /> 7300 CHEVRON WAY 2035 E.15711 ST. 11190 PENROSE ST. <br /> DIXON,CA 95620 LA,CA 90021 SUN VALLEY,CA 91352 <br /> 707-693-6006 213-746-0237 818-787-2649 <br /> EPA#CAT080012602 EPA#CAL000270577 EPA#CAL000379059 <br /> MPC(V=3) <br />