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AmERICAN VALLEY 153620 <br /> WASTE OIL, INC. Invoice 4uinber: <br /> P.O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 ° FAX 209-668-3880 <br /> EPA# CAL000416714 <br /> SILL TO; JOB SITE:('��i�'. C�.t�� ���-��" `Inv`oice Date: <br /> S CC' 'T <br /> Phone Customer P.O. Terms EPA# / �7 <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 /> r <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used Oil Filters <br /> f� C- r 11`_ t)A 1 q13 <br /> i <br /> TOTAL <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees it court action 7 q.L'o <br /> becomes necessary to collect this invoice: <br /> her <br /> waste do 11 s not contain any pC8s.I have complied with the requirements fof the waste described the applicable ove With Cal form used rdous of management aste,the total regulation to determinealide content is LE�SS r his Is true.I ppm, <br /> eto he <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 <br /> racticable method of <br /> wh ch minimizes the present and future threat t human life randlthe nv ronment:or,if I am at I have selected a small quantity generator,I have made a Goodfath effort to minimizosal currently e my waste <br /> generation and select the waste management method that is available#o me that I can afford. <br /> American Vailey Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility that a required to comply with federal <br /> regulations4pplicable to management of used oil,but that.is not required to comply with the more stringent req nd some applicable to hazardous waste management fame <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 ail 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 parties signing.this invoice it will serve as an agreement that American Vallste Oil will submit con <br /> ey Wafirmation for(certain waste streams)to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR1 <br /> I AUTHORIZED DATE: <br /> DATE: -���r r l7 SIGNATURE: <br /> SIGNATURE:VER <br /> S ,� FP�, � - -- <br /> F-DISPOSAL 1 RECYCLING FACILITY Q CLOBALMATERIALMGMT <br /> ON © ASBURY ENVIRONMENTALORIVERBANK OILTRANSFER O CFR 2035 E.15TH ST. 1640 N.BROADWAY <br /> HEVRON WAY `� 1920 MORGAN RD. 5300 CLAUS RD. STOCKTON,CA 95205 <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 LA,CA 90021 <br /> 209-863-8181 213-746-0237 818 770-2577 <br /> 707-693-6008 707-693-6008 EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br /> EPA#CAT080012602 EPA#CAL000393680 <br /> MPC(t. <br />