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AMERICAN VALLEY 138037 <br /> WAST , Invoice Number: <br /> E OILINC. <br /> P. O. Box 340 ® Delhi, CA 95315 <br /> PH. 1-800-732-4645 s FAX 209-668-3880 <br /> EPA#CAL000827878 <br /> J KC T RUCF,,l NiG, <br /> J <br /> '0-7 RLI-'<�NG <br /> 3400 NNEDWTON IRD <br /> BILL TO: CA 95206 JOB SITE: Dl r2 Invoice Date: <br /> � CA <br /> Phone,-` Customer P.O. Terms*ksj;� &" EIPA#iZ-Ai-000,&D!52?8 <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 /> r DJE D.RAS'l 1'2 <br /> �7: 7 <br /> RiC <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 certifythat I have rot mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than!,Doc ppm, <br /> ,and the waste does rot contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to determine chis is <br /> true.I agree to accel 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 <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 maragernent method that is ava ilable 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 transferfacility. <br /> GENERATOR/ <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE: SIGNATURE: DATE: <br /> DISPOSAL / RECYCLING FACILITY <br /> 0 DK-DIXON 0 CFR 0 UNITED ENTERPRISES CORP <br /> 7300 CHEVRON WAY 2035 E. 15TH ST. 11190 PE NROSE ST. <br /> [DIXON, CA 95520 LA,CA 90021 SUN VALLEY.CA 9135.2 <br /> 707-693-6008 213-746-0237 81.8-787-2549 <br /> EPA4 CAT080012602 EPA#CAL000270577 EPA#QAL000379059 <br />