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AMERICAN VALLEY 139595 <br /> WASTE OIL; INC. Invoice Number: <br /> R O. Box 340 • Delhi, CA 95315 <br /> PH. 1-800-732-4645 9 FAX 209-668-3880 <br /> EPA#CAL000827878 <br /> DURA FLAME WEST DURAFLAME4- <br /> BILL TO: 1340WEST WiASHiNGTON JOB SITE: 1340 W,WASHINGTON ST nvoice Date: <br /> STOCKTON,CA 95203 :STOCKTON,CA 952015 <br /> Sales Rep <br /> Phone2D9-.944-5800 Customer P.Q. TermsMat30Dap EPA#CA' L 44 <br /> E <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 /> Drained Used Oil Filters <br /> UNIVERSAL WASTE-ALKALINE BATTERIES { ri <br /> UNIVERSAL WASTE-NON-PCB BATLAST <br /> qur <br /> UNIVERSAL WAS �AitMPSMtiUN! 600kTA11IONCHG <br /> w <br /> ---UNIVE*�WWAZIE-4JW-U:UIRAJGHrIA PS <br /> i <br /> Saw I ax <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court a 'on TOTALL <br /> becomes necessary to collect this invoice. 4L <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 Mown. <br /> and the waste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to det'eerrmiin{ee this iss <br /> true.I agree to accept the additional charges for the disposal of th iswaste if the information I have provldW about this waste is incorrect. r '"� "'m r <br /> Generators 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 <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 threat to human life and the environment:Or,if I am 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 /> 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 <br /> that their waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> DRIV - AUTHORIZED ' <br /> 6900ATURE: DATE: ( 21,& IGNATURE. DATE: Q . _ .. <br /> DI Aldf <br /> R.a , . LING FACILITY <br /> © DK-DIXON O CFR 0 UNITED ENTERPRISES CORP <br /> 7300 CHE WAY 2035 E.15TH ST. 11190 PENROSE ST. <br /> DIXOIV 95820 t A,CA 90021 SUN VALLEY,CA 91352 <br /> 707-6 -8008 213-746-0237 818-787-2649 <br /> EPA#CAT080012602 EPA#CAL000270577 EPA#.CAL000379059 <br /> MPC(6/2013) <br />