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AMERICAN VALLEY <br /> WASTE OIL, mc. Invoice Number. <br /> P.O. Box 340 - Delhi, CA 95315 <br /> PH. 1-800-732-4645 - FAX 209-668-3880 <br /> EPA# CAL000416714 <br /> BI r L TO: <br /> JOB SITE <br /> -; Invoice Date: <br /> P�Cnp Customer P.O. Terms EPA# <br /> i <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST <br /> WASTE OUANTITYJ PRICE AMOUNT <br /> CODE <br /> I k <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 F <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used Oil Filters <br /> I <br /> TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action <br /> becomes necessary to collect this invoice, TOTAL <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 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 /> accept the additional charges for 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 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 availabl <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 minie to me <br /> mize ml 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 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 meat I <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 f <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 asagreement 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 <br /> or transfer facility. <br /> DRIVER GENERATOR/ t' <br /> SIGNATURE AUTHORIZED t <br /> DATE: SIGNATURE: DATE: <br /> DISP®SAL I RECYCLING FACILITY <br /> Q DK-DIXON Q ASBURY ENVIRONMENTAL Q RIVERBANK OILTRANSFER Q CFR Q GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E. 15TH ST. 1640 N. <br /> WAY <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA95367 LA,CA 90021 STOCKTON,,CDA 95205 <br /> 707-693-6008 707-693-6008 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br />