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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# CAL000416714 <br /> A&SOCIA-j'E:D 1 Ks-t , <br /> BILL TO: ]OB SITE: 1323 VV_ `'HAPTEIR WA' Invoice Date: <br /> XARGONAUT&FRESNO <br /> SrOCKTON, C;A, 952176 <br /> Phone Customer P.O Terms rs�v� EPA# <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 233 <br /> Drained Used Oil Filters <br /> ".X COLLECTION EEE <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,Ooo ppm,and the <br /> waste does not contain any PCBs.I have compiled 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 ahout this 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 the volume and toxicity of waste generat- <br /> ed to the degree I have determined to be economically affordable and that 1 have selected the practicabie 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 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 handie 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 lawful to send used ail to 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 servo as an agreement that Arnerican 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 /> GENERATORI <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE: SIGNATURE: DATE: <br /> DISPOSAL / RECYCLING FACILITY <br /> O DK—DIXON O ASBURY ENV�RCNMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E. 15TH ST. 1640 N.BROADWAY <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 LA, CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 707-693-6008 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CAT080012602 1 CAL000393680 EPA#CAL000190816 1 CAL000270577 EPA#CAL000417316 <br /> MPC(712016) <br />