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AMERICAN VALLEY <br /> WASTE OIL, INC. Incite Number: <br /> P.O. Bax 340 - Delhi, CA 95315 <br /> PH. 1-800-732-4645 - FAX 209-658-3880 <br /> EPA#CAL000416714 <br /> BILL TO:- N&S TRJXC-OR JOB SITE: N&S TRACTOF� env ice Date: <br /> P,C3 Bax 9'10 - 1340 W.CHARTER WAY <br /> MERCED,CA 95341 STOCKTON,CA 9fi2&G6 <br /> 1M OIL <br /> Saes Re <br /> Phone Customer P.O. Terms EPA# <br /> X09-944-5500 JOHN Net SO Days CAL004255406 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RC RA Waste Liquid Used Oil/Mixed Oils 221 <br /> A u g" 100 -k <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used Oil Filters <br /> COLLECTiOiN FEE 17 Min co <br /> S 1b177 <br /> P/0, - 9 .eo <br /> 17 V0 <br /> Sales lax <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. 4 <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 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 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,it 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 /> regufations 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 cut-of-state facilitles 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 oil 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 partles signing this invoice it will serve as an agreement that American Val fey Waste OiI wilt submit confirmation for(certain waste streams)to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. F <br /> GENERATOR/ <br /> DRIVERf� AUTHORIZED r ��;� ` <br /> SIGNATURE: /. f'��,' n; DATE: 171 11 SIGNATURE: �.-- r. �j :'� � � DAM--/-_- •'. <br /> .74 <br /> u <br /> 'SPOSAL 1 RECYCLING FACILITY <br /> 0 DK-DIXON Y ASBURY ENVIRONMENTAL Q RIVERBANK OILTRANSFER O CFR Q GLOBAL MATERIAL MGMT <br /> 7304 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 EPA#CAL000393680, EPA#CAL000190816 EPA#CAL-000270S77 EPA#CAL000417316 <br /> MPC 9/2016) <br />