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V <br />y <br />AMERICAN VALLI, <br />WASTE OIL, INC. <br />P.O. Box 340 ® Delhi, CA 95315 <br />PH. 1-800-732-4645 - FAX 209-668-3880 <br />EPA# CAR000272302 <br />ENI EPEU r') '3 ""(Vlj <br />BILL TO: <br />JOB SITE : ik"I­f, A� <br />£" �._kV L' 5C (_-t <br />q <br />.<t <br />Invoice Nui4er. <br />Invoice Date: <br />Phone <br />Customer P.O. <br />Terms <br />!A <br />f <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water <br />223 <br />Compliant Drained Used Metal Oil Filters <br />F -i L <br />2) <br />C <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. Customer ageee <br />,s_to, pay, All -legal fees it court action <br />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 contontjs LESS than 1,000 ppm, and the <br />wastedoes 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 I 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, 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 />regulation's 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 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 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/ <br />DRIVER 'AUTHORIZED <br />SIGNATURE: DATE SIGNATURE: DATE: <br />DISPOSAL/ RECYCLING FACILITY <br />0 DK-DIXON 0 ASBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 YUMA YES LLC 0 AMERICAN VALLEY WASTE OIL, ING <br />7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 i 521 INDUSTRIAL DR STE M <br />DIXON, CA 95620 CERES, CA 95358 RIVERBANK, CA 95367 YUMA, AZ 85365 LIVINGSTON, CA 95334 <br />707-693-6008 209-541-1825 209-863-8181 928.344-9828 209-667-8857 <br />EPA# CAT080012602 EPA41 CAL000393680 EPA# CAL000190816 EPA# AZR000521146 EPA# CAL000443004 <br />MP(' (719nlAI <br />