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RECEIVED AMERICAN VALLEY 177118 WASTE OIL, INC. Invoice Number: Oct 4, 201 9 P.O. Box 340 - Delhi, CA 95315 PH. 1-800-732-4645 - FAX 209-668-3880 EPA# CAR000272302 0. BILL T I-0111VALLir-i 71iJOB SITE: '1�voice Date: 0 6,K}.A LE, CA 95,16 1 j A Phone 2Q9-46 1-1 IVO KEN . Customer P.O. Terms EPA# x-I PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUAN[TrM PRICE AMOUNT CODE 7- NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 NON-RCRA Waste Liquid Used Oily Water 223 Compliant Drained Used Metal Oil Filters MID VALLEY AQ. DATE: _qz2rjLA_-.19 ACC TERMS; Invoices over 30 Days re subject to a 1.5%service charge. Customer agrees o pay all legal fees if court action becomes necessary to collect this invoice. TOTAL By signing I herby certify that I hav a not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than 11,0130 ppm,and the waste does not contain ariy PICBs.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree to accept the additional charges for I t e disposal of this waste If the information I have provided about this waste is incorrect. Generator's Certiccation:By signin g I certify that it I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generat- ed to the degree I have determinac to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and ft lure threat to human lite and the environment:Or,if I am a smallquantity generator,I have made a Good faith effort to minimize my waste generation and select the waste m linagement method that is available to me that I can afford. American Valley Waste Oil hereby i civises the above Generator that generators shipment of used oil may be transported to a facility that is required to comply with federal regulations applicable to manage ent of used oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facili- ties.California facirlids 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 those requirements,engineering cE rtifications of tank integrity,and financial assurances for closure and accidental releases.It is lawful to send used oil to out of state fac[li that comply only with,federal used oil management standards and not these more stringent requirements. lies This notification is for information r urposes,only. 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 waste has been transported to a U ensed treatment or transfer facility, GENERATOR/ DRIVER'- UT HO SIGNATURE: DATE: DATE: DISPOSAL ICErK��QE' CILITY 0 DK-DIXON Q A 33BURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 YUMA YES LLCAMERICAN VALLEY WASTE OIL,INC 7300 CHEVRON WAV 11�20 MORGAN RD. 6300 CLAUS RD. 6500 US HVVY 95 •��_521 INDUSTRIAL DR STE M DIXON,CA 95680 C ERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 707-693-6008 2(9-541-1825 209-863-8181 928-344-9828 209-667-8857 EPA#CAT080012602 E!'A#CAL000393680 EPA#CAL0001 90816 EPA#AZR000521146 EPA#CAL000443004 MPC(7/2016)