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LSI mC"AN VALLEY <br /> WASTE OIL, INC. voice Number: <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 • FAX 209-668-3880 <br /> EPA#CAL000827878 <br /> MORGAN AUTO REPAIR <br /> BILL TO: 4171 IND'iJSTRIAL WAY JOB SITE: MORGAN AUTO REPAI R <br /> TRACY,CA 95304 7710 MURRAY DR . voice Date: <br /> STOt KTON,CA �62)05 <br /> '41 O;L <br /> Safes Rep MIKE HUBTR <br /> Phone2fA-3.35.49£I9511L Customer P.O. Terms,Net 30 Days EPA#C4L0D0 +101 <br /> r <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRIC AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221D; d �� per! Hyl <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> QUE NCRUDEDIL <br /> PRICES,WE HAVE BEEN FORCED TO <br /> CHANGE PRICING FOR WASTE O€LAND <br /> `i=i ar, PZ . UP. <br /> rpt n <br /> TERMS; Invoices over 30 Days are subiect 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 l 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.l agree to accept the additional charges for the disposal of this waste if the information l 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 ad 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, 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 mIde a good faith <br /> .effort to minimize my waste generation and select the waste management method that is ava liable 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 stream)to the generator <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> DRIVERwy- %!,• f�; GENERATOR/ <br /> ', <br /> SIGNATURE DATEAUTHORIZED <br /> GNATURE <br /> j <br /> DATE. <br /> DISPOSAL l RECYCLING FACILITY <br /> ( / DI(-DIXON O CFR O UNITED ENTERPRISES CORP <br /> 7300 CHEVRON WAY 2035 f.16TH 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(62013) <br />