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�� <br /> AMERICAN (., �. .� '% <br /> WASTE 9L9 Invoice Number: <br /> p.0. Box 340 •. Delhi, CA 05315 <br /> PH. 1-800-732-4645..® FAX 20.-668-3880 <br /> EPA# CAR000272302 <br /> CP I L INC , F4,EE F , > — <br /> jI; t <br /> BILL TO: JOB SI'D'E �s Invoice Date: <br /> LOO! CA 955241 <br /> Customer P.O. Terms EPA# <br /> }' <br /> Phone 4624 ".3 <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST. QUANTITY PRICE AMOUNT <br /> WASTE <br /> CODE <br /> NON-RCRA Waste Liquid.Used Oil/Mixed Oils 221 <br /> i NON=RCRA Waste.Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> compliant Drained Used Metal Oil Filters <br /> iK, <br /> df4 <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service.cha[ge. Customer agrees to day all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing i herby certify fnat i have not mixed any of the waste describecl.above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the . <br /> waste does not contain any PCBs.I have complied With them <br /> .requireents of the applicable California used.oil,management regulation to determine this is true.I agree to <br /> accept the additional charges for the disposal of this waste if the information I have provided aboutthis 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.tfie volume and toxicity of waste le to t- <br /> ed to the degree I have determined to be economically affordable and that f have selected the practicable method of treatment,storage,or disposal currently available to me <br /> 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 effort to minimize my waste <br /> generation and select the waste management method that is available to rile that I can afford. <br /> American Valley Waste Oil hereby advises ty L With federal <br /> he above Generator that generators shipment the more st nofuged oil yent requiremenbe dts applicabletto hazardohat is re L lusdw was ana-to camp l)agementt facili- <br /> regulations applicable to management of used oil,but that is not required to comply w 9 <br /> ties:California facilities that handle or process used oil are required to meet those more stringent requirement,and some out of-state facilities that process used oil also meet <br /> those requirements engi.neeriilg certifications of tank integrity,and financial assurances for closure aid accidental releases.It is lawful to send used oil to out of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirem)nts. <br /> This notification is for information purposes only. <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 that their <br /> waste has been transported to a licensed treatment or transfer facility: I <br /> GENERATOR/ t <br /> f AUTHORIZED DATE: <br /> DRIVER SIGNATURE " <br /> SIGNATURE'. C -<C:..,. PATE:" %r 1 <br /> DISPQSAL/ RECYCLING FACILITY <br /> AMERICAN VALLEY WASTe OIL,INC <br /> Q DK OIXO:N Q ASBURY ENVIRONMENTAL O RIVERBANK OIL TRAN;,FER O.PUMA YES LLC. U. 521 INDUSTRIAL:DR STE M <br /> 7300 CHEVRON WAY 1920.MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 LIVINGSTON;CA 95334 <br /> D1XON,•GA 95620 ES,CA 95358: RIVERBANK, CA 95367 YUMA,AZ85365: 209-667-8857 <br /> 707-698-6608 209 541=1825 209 863 8181 928 344 9828 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 E:PA#AZ80005211.46 EPA#GAL000443004 <br /> - - - MPG(7/2016) <br />