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A AMERICAN VALLEY A WASTE OIL, INC. Invoice Number: P.O. Box 340 - Delhi, CA 95315 PH. 1-800-732-4645 - FAX 209-668-3880 EPA#CAR000272302 BILL TO: JOB SITE: L t A-.N C.H PA Pf'--k Invoice Date: 4..101 1-: FRF M01`4 I'IS i 4/.1')I I.. I':R F MO N S T V -l"FOC'MON. GA 95?1)1 SVOCKIQN. CA Phone Customer P.O. Terms EPA# MV-36 (,A 0003 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUAIvT 111 y PRICE AMOUNT CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 NON-RCRA Waste Liquid Used Oily Water 223 Drained Used Oil Filters OiL C(XLECI ION FEE Tax TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees If court action TOTAL becomes necessary to collect this Invoice. By signing I herby certify 11111.1 11OVe not MIXod any of the waste described ab cjve with any other haZardicUs waste,the total halide content is LESS than I(too ppm and the .waste does not contain any PCBs.I have complied wlih the requirements of the appileabl®California used oil rnanagoolent regulation to determine this Is time.I agree to accapt the additional charges for the di.sposal of this waste If the Information I have provided about this waste is incorrect. Generator's Cart'[111:460m By signing I corwy that if l am a large quantity generator,I certify fhat I have a program in place to reduce ihevolume and toxicity of waste generat- ed to the degree I have determined to be ecul)*1111cally affordable and that I have selected the practicable method of treatment,storaga,or dispDoal currently available to me which mJnImizes the present and rumire threat to human life and the environment:Or,if I am a small quantity gerierator.I have made a Good faith olfcrl to minimize my waNto generation and select the waste mn nag emant method that is available to me I IN at 1 can atford. American Valley Waste()It hereby advises the ahovs Generator that generators shipment of used all may be transported to a facility that is required to comply with federal a g ulal lon S applicable to management of used oil,but I hril is not requ rred to comply with the mora stringent requirements applicable to hazardous waste management fs:0111- I [I also I les.Cal Ifornla foci I I U as Ih at handle of process used oil are required to meet those os�more stringent req ul re r r ier%and soma out-at-Plate facilities t it at P rcOess used 0 meet those raquimments,englvaering cartIlIcalions of tank SntKrlt%and financial assurances for closure and HorldemAl releases.it In lawful to send used oil to out of state facilities that Wmply only with federal used oil ma no quinom sl ands rd3 and got these more stringent requiramutill 6 This notification is for information purposes only. By both parties signing this Invoice It will serve as an agreement that American Valley Waste Oil will submit confinria (WWnwaste streams)to the generator that their waste has been transported to a licensed treatment or transfer facility. GENERATOR/ AUTHORIZED SIGNATURE SIGNATUPE: DRIVER OAT/ Q1_3PaaAL RECYCLING FACILITY 0 DK-DIXON 0 ASBURY ENVIRONMENTAL ( )RIVERBANK OILTRANSFER 0 CFR 0 GLOBAL MATERIAL IVIGIVIT 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 2035 E.15TH ST. 1640 N.BROADWAY DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 LA,CA 90021 STOCKTON,CA 95205 707-693-6008 209-541-1825 209-863-6181 213.746-0237 818-770-2577 EPA#CAT080012602 EPA#CAL000393680 EPA#CAL0001 90816 EPA#CAL000270577 EPA#CAL00041731 6 MPC(7/2016)