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AMERICAN VALLEY 161633 <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: FLEENOR PAPER 00 <br /> 4201 E.FREMONT ST TOB SITE: �� rC:fatlf PAPER C,0 Invooiceice Date: <br /> STOCKTON, CA 95215 4:x'.01 E, FREMONT 8 <br /> STOCK[ON,CA 952,15 <br /> a 1_ _ . a <br /> Phone Customer P.O. r� Terms �� EPA1F <br /> 209-361-8698 JOSU E G.O.D <br /> _ r1A 1.000 318085 <br /> PRODUCT SHIPPING DESCRIPTION MANIFEST CfUAIV I IIT PRICE AMOUNT <br /> WASTE <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 ' <br /> NON-RCRA Waste Liquid Used Antifreeze 133 r <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters " <br /> OiL COLLECTION FEE <br /> - — Snkm Tax <br /> TERMS: Invoices over 30 Days ara stlbjeul to a 1.5%service charge. Customer agrees to pay all leg—Al fees if court action TOTAL <br /> becomes necessary to polleef this Invalcv. <br /> r� <br /> By signing I herby certify That I have oat mixed any of Ifo waste desorlbed ahove with any other nazacdous waste,[iris IaIoi h8 fide content Is LESS than 1.000 ppm,and the <br /> waste does not contain any I'Mo,I have txlmptled with the requirements of the applicable California lased oil managarnent regulation to datefrinine this to true.I agrea to <br /> arcapl the add it Iona[chagrFs for the disposal of Ihis waste if the Information i have providird about this waste Is Incorrect. <br /> GF."1 ratw1c rPrilI catiom By tsiG1nInq I certIty[loll if 1 Rm n Virgo gLIXildty 9Dom atr,,i;I nerlrfy That I linve a Program In PlaCo to red UeO I h D volume and toAclty Of waSte A011(11at- <br /> ad 1o.lh0(1119 Ma I have dotannInso to.be acono Nally 0ffordabte and#✓sat I Ili)v(%aelocled fhe praclIcable method Of lroatmen1.storage,or dinposal curtontiy avail✓+bio to me <br /> whfeh fit InIm11es the prsseni and future Ihrapl to 1luman llfar and thea environalMllt Or;iI I OM n 3111011 quantify aonorator,I have inodo a Goad Inlfh eflerl to minimtzn my waste <br /> gomeratIon and sated itla wa3to managamani nsfrlltocl Ihnt is avaiIawe to rile that I can nIrord, <br /> African Valley waste Oil hamby tsdviarrs Ilia above Genndor that gonemtors stllprnent at uiled oil rnny be irnnsltor erl to a far.111iy ihnt is mquired to comply w1111 fndk tuil <br /> F*g1.11a,Ions epplioabin to Fri anagiotrrit of uFie d oll,but that fn not requited to nompiy wlIh 111e morn alringent req uiImmonIs appllrtibia to hftz moue Wasla matfagantei7t fncfll- <br /> lirfs.GnlEfy[nlls facilltlns that hnndka or droe+taa.urod✓111 err regtnred to irrr nt Shone snare iIrtngen(rrrrfulrrrmow,antl 5aine oui-or-stale fst:tiltfrin lisel prounm user,[oil also meet <br /> Ihrsn tostulrPennnla,enginnering ctrrfll}ostima of tank lnlrg Hly.and Aroinc.01 Afto faces for r-.lomrra ani}accidental rrdetlaorr.I:t8 lawful to send Uadd Olt 10 nut of ntnte facllittos <br /> 1101 Comply only wllh fudaml 1j"d oil inanagoment stanonfds ant net Ihnaa rnere atrinpant requirements. <br /> This notification is for informatlon purposes only. <br /> By both parties signing thl3 Invoice it will RAM1e as an agreement that American Valley Waste Oil will submit confirmation for(certain wa to•atfoanls)to the generator that their <br /> waste has been transported to a licortisod trealment or transfor kroioty. <br /> GENERATOR! <br /> DRIVER 00 AUTHORIZED <br /> SIGNATURE: DATE: /, ,SIGNATURE: f r { DATE: <br /> DUP—MA—L RE !YC dN--Q—FAG1LMY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL RIVERBANK 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(7/2016) <br />