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07/14/2015 17:18 <br />BILL TO: <br />5107963470 SHARMA <br />AMERICAN VALLEY <br />WASTE OIL, INC. <br />F), 0. Box 340 • Delhi, CA 95315 <br />PH, 1-800-732-4645 • FAX 209-668-3880 <br />EPA# CAL000827878 <br />ARCO AlVliPM yosEmiTE <br />JOB SITE: 1711 5- Y(DSCOITF MAN T t!CA, CA <br />PAGE 08 <br />135996 <br />Invoice Number: <br />CLie ctcl <br />/-; <br />lnvoiá Date: <br />c,',0 AM/Phi. YO$E10;TE <br />1711E_ YOSMiTE <br />MANIF_-CA. CA <br />PRODUCT SHIPPING DESCRIPTION <br />9oo..R2,16,6111._ <br />Phone 171:Titomer P.O. <br />WASTE <br />CODE <br />aelOS Rep <br />Terms46MNIP EpA#-A'a-07750 <br />CC). <br />MANIFEST <br />QUANTITY AMOUNT PRICE <br />NON-RCRA Waste Liquid Used Oil/Mixed 01Is 221 <br />NON-FIORA Waste Liquid Used Antifreeze 133 <br />NON-RCRA Waste Liquid Used 011y Water <br />Draioed,Usecl.011.Eiliers— • <br />223 <br />/ C4AF <br />OUE TO THE DRA SIC FALL IN CRUDE oft <br />tn rs,wp e-aviu FIEF 64 Pe-14,clEr) 10 <br />CklAtitriE PRICING' FOR WASTE Oft ANO <br />FILTER PICK UP. <br />Sates a)t <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. Customer agrees to pay all legal fees if court action becomes necessary to collect this Invoice, TOTAL <br />41:1Li <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 I.155 than 1,000 ppm, <br />ancrthe waste does not contain any PCBs. I have complied with the requirements of the applicable California used nil management regulation to determine 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 />Generator's Certification: By signing I certify that if I am a large quantity generator, ( 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 threet to human life and the environment: Or, If Jam 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 />fly 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 />DRIVER <br />SIGNATU <br />GENERATOR/ <br />t /6 ,,,,,ALYTHORIZED <br />A„ SIGNATURE; -AL,".”, <br />DISPOSAL / RECYCLING FACILITY <br />OK-DIXON _ 0 CFR <br />/ 7300 CHEVRON WAY 2035 E, 15TH ST, <br />DIXON, CA 95820 LA, CA 90021 <br />707-693-6008 213748-0237 <br />EPA# CAT080012802 EPA# CAL000270577 <br />0 UNITED ENTERPRISES CORP <br />11190 PENROSE ST <br />SUN VALLEY, CA 91352 <br />818-787-2648 <br />EPA# CAL000379059 <br />RECEiVEL <br /> <br />JUL 1 5 2015 <br />ENVIRONMENTAL <br />tec (6/201a) <br />