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EMCAN VALLEY 2 9 0 2.0 <br /> ERI <br /> WASTE OIL, I ivoice Number: <br /> P.O..Box 340 • Delhi, CA 95315 <br /> PH.1-800-732-4645 • FAX 209-668-3880 <br /> EPA#CAL000827878 f <br /> VORGANAUTOREPRfR <br /> BILL TO: <br /> Mi ORGAN AUTO 1EPAI 12 JOB SITE: 7740 MURRAY OR ° oice Date: <br /> 41711NDUSTMAL V!`AY STOCKTON,CA 9570 <br /> TFACY,CA 96304 1M 03L <br /> Safes Rao.. MIKE HUSER <br /> Phone Customer PO. Terms EPA# <br /> 209-836.909 BILL Na}3o Days CAL000^ 2101 <br /> PRODUCT.SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON'-RCRA Waste Liquid Used OiVMixed Oils 221 l 37 ? ' <br /> NON-RCRA Waste Liquid Used Antifreeze 133 L <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> r-. <br /> Sales 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 L than 1,000 ppm, <br /> and thewoste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to etermine this Is. <br /> true.I agree to accept the additional charges for the disposal of this waste if the information I have provided about this waste Is incorrect. <br /> Generators 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 a id 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,)have n ade a good faith <br /> effort to minimize my waste generation and select the waste management method that is available tome that can afford. - <br /> By both parties signing this invoice It will serve as an agreement that American Valley Waste 011 will submit confirmation for(certain waste strea s)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> of � <br /> f GENERATOR( ( ': <br /> DRIVER AUTHORIZED' <br /> SIGNATURE; �,v,✓' DATEt'�j��f�' `f <br /> rf SIGNATURE + DATEJf'a/`?f% <br /> DISPOSAL/ RECYCLING FACILITY . <br /> 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 818-787-2649 <br /> EPA#CAT080012602 EPA#.CAL000270577 EPA#CAL000379059 - <br /> MPC(6 013) <br />