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r' <br /> AMERICAN VALLEY 15 s l 6 5 <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 <br /> BILL TO: F l-LLNOR PAPER CO JOB SITE: FLEENOR PAPFR C C) Invoice Date: <br /> 4201 F_, FREMONT ST 4201 E FREMON T S'. <br /> 8 FOC'.K'I ON, CA 9,5215 STUCKTUN,CA 95215 <br /> F> kis Rep <br /> Phone2c)9_36-1-8698`I08UE Customer P.O. Terms oz., EPA# <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTFTY 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 , r <br /> Drained Used Oil Filters <br /> COIL COLLECTION FEE <br /> Salm f a% <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 00 <br /> becomes necessary to goilect this invoice, <br /> By signing I herby certify[fiat I have not mixed any of the waste described above wllh any other haxardnus waste.ilia lotel halide content is LESS than 1,400 ppm,and the <br /> waste does not contain any POes.I have compiled with the raqulremants of the appWoable Crlliforrtia used oil manwument regulation to determine this is true.I agree to <br /> accept The additinnni charges for lite disposal Of tills waste if the Information I have prevhled about lws waste Is Incurrgcl, <br /> Lienaralor"8 Certification:By signing I r,rxtlfy that it I area large quantity yonurator,I Cerwy that I nava a program In place to reduce ilm volume and toxicity of waslaganamt- <br /> ed to the degree I have ctetormlned To ba egarlcmicafly affanlaota and that 1 have Selected the preol cable method Of treatmen1.nlorage,or dispegal durrunily avaiklilla to rile <br /> whlc:h minimizes[lie present and louvre Threat to human life and the environmont:Or.f1 f am a amali quantity generator,I have made a Good faith effort to minimize my waste <br /> gaiwaticn and select the waste management method that Is available to me that I can offero- <br /> Amerloan Valley Waste Oli hereby advises the above Generator Ihat generators aNpment of used oil may be transported To a facility that is required to ovmply with federal <br /> rrlqulatinna appkabt*to manttg6mant Of used all,but that is not required to comply with aha more slrinWnt n3quIremmnta appllcnble to hazardous Waste mansgament faclll- <br /> ttas.Crrllforntit fsai6Hies that lie ndlo or prncena used all nre required to meet 1lltlse mom 91Finganl requ I renien t.and some out-i:)f-dole facilities that fni' oaq Meed Fill alas meal <br /> those requlrarrlenls,engineering certlficallons of lanh Irnmprity,and ltnRriolal assurances for 0osurn and academe!releases II is lawful to send used oil to 0jit of stale f idklles <br /> that corpptyonly with federal!pd all msnanerrser11 standards And not these mgm elnngent 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 streaM§)to the generator that their <br /> waste has been transported to a licensed treatment or transfer facility. <br /> DRIVER GENERATOR/ <br /> - AUTHORIZED <br /> SIGNATURE0. ~DATE: SIGNATURE; DATE; - - <br /> I <br /> DISPOSAL 18ECYQLLNG FACILITY- <br /> O Dki.DIXON O ASBURY ENVIRONMENTAL IVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 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#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br /> MPC(712016) <br /> I _ <br />