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i - <br /> ? AMERICAN VALLEY 164930 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340•Delhi, CA 95315 <br /> PH. 1-800-732-4645•FAX 209-668-3880 <br /> EPA#CAR000272302 E5 <br /> BILI.TO; AGUILI_ES AUTO BODY REPAIR OB SITE: AGUILLES AUTO BODY REIIFnvoice Cf`► <br /> Date: <br /> 480 E.11TH ST 480E P.A <br /> 11TH ST <br /> CALL AHEAD CALL AHEAD <br /> TRACY,CA 95304 TRACY,CA 95304 <br /> J�6b <br /> Phone 209431-9603 Customer P.O. CALL AHEAD Terms C.O.D. EPA# CALOD0385491 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 oc�3�3-d5 <br /> a � <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> OIL COLLECTION FEE <br /> TERMS, Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legaE fees it court action TOTAL <br /> becomes necessary to collect this invoice. / <br /> By signing Iherby certify that I have not mixed any of the waste described above with any other hazardous waste,the iota{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 /> aLrcept the additional charges fpr the disposal of this waste It the information I have provided about this waste Is incorrect. <br /> Generator's Certification:By signing I certify that If I am a large quarnity 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,It€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 /> regulations appiloable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management fatui- <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 compty 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 /> DRIVER [� <br /> GENERATORI <br /> SIGNATURE. DATE: )+4 ''AUTHORIZEDSIGNATUR &J-0 1 DATE.rj`'�]��� <br /> E: CJ tT 1 <br /> DISPOSAL.1 RECYC NG FACILITY <br /> O DK-DIXON SBURYENVIRONMENTAL Q RIVER13ANK OIL TRANSFER O OFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RB. 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 209-541-1825 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#GAT080012602 EPA#CAL000393680 EPA#CAL00019081e EPA#CAL000270677 EPA#CAL000417316 <br /> ul�n.l�rzotsY <br />