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AMERICAN VALLEY <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PH, 1-800-732-4645 • FAX 209-668-3880 <br /> EPA# CAR000272302 <br /> BILL TO: <br /> ASSOC]A ItU rRAG��k VEIVI Ir , JOB SITE: ASSOCIATEDTR.ACTOR VEff <br /> 34 lel. VENTURA RU. 34 N. VENTURA RE) Invoice Date: <br /> al'"K ION, LA %;�06 STOGKTON,CA 952U6 <br /> Phone u9_�lbt�su�� Customer P.O. Terms EPA# <br /> I*t3ODdy <br /> PRODUCT SHIPPING DESCRIPTION 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 /> Compliant Drained Used Metal Oil Filters <br /> O V),1,".--I rL I-1_, +ll' .ls,I-,IA LL)LL h <br /> h t 7A L t-11!L-JH 0-N €_:L-►1 t bd L-t. f,�L- <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,and the <br /> waste does not contain any PCBs.I have complied with the requirements 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 about this waste is incorrect. <br /> Generator's Certification:By signing E certify that it I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generat- <br /> ed to the degree I have determined to be economically affordable and tPfat f have selected the practicable method of treatment,storage,or disposal currentiy 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 me that I can afford. <br /> American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility that is required to comply with federal <br /> regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facili- <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,engineering certifications of tank integrity,and financial assurances for closure and accidental releases.It is IawfULtQ send used oil t, ,out of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <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. <br /> :� GENERATOR! / t <br /> DRIVER �' AUTHORIZED r <br /> SIGNATURE: DATE; SIGNATURE: / �� DATE: <br /> DISPOSAL / RECYCLING FACILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O YUMAYES LLC Q AMERICAN VALLEY WASTE CIL.INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US MWY 95 521 INDUSTRIAL DR STEM <br /> DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CA95367 YUMA,AZ85365 LIVINGSTON,CA 95334 <br /> 707-693-6008 209-541-1B25 209-863-B181 928-344-9828 209-667-BB57 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC(712016) <br />