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r AMERICAN VALLEY Q3 '?j 2 WASTE OIL, INC. Invoice Number: P.O. Box 340 • Delhi, CA 95315 PH. 1-800-732-4645 • FAX 209-668-3880 EPA#CAR000272302 FLEENOR PAPER 00 BILL TO: 4201 E.FREMONT ST JOB SITE: FLEE NOR PAPER Cha Invoice Date: STOCKTON, r A 951.15 420'1 E, FREMONT ST STOCKI'GN,CA %216 Phone 208-351-8698J+0,%)r ustomer P.O. Terms EPA# GAL:CC0318085 760 8 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY 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 "a �`i.i'. Drained Used Oil Filters OIL COLLECTION FEE 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 necessary to collect this Invoice. '•=r�, By signing I herby certify that I have not mixed any of the waste deserlbod above with arty outer liaxardous waste,the total halide content Is LESS than 1,0[70 ppm,and the Waste does not contain any PCBs.I have compiled with the requirements of the applicable California used oil management regulation to determine this is true.I agree to accept the additional charges for the disposal of this waste 11 the Information I have provided about this waste la Incorrect. General ar's Certfficatiom By signfng i certlfy that If 1 am a Wrga quantity ganerator,I curllfy that I have a program In place to reduce the volume and toxielty of waste generat- ed to the degree I have detsrminad to be ec:anomically affordable and that I have selected the practicable method of treatment,stornga,or disposal currently available to me which minimizes the present god future ntreat to human fife and the environment:Or,It I am a smn11 quantity generator.I have made a Good faith afforl to minlmlze my waste generation and select Iho waste management method that Is available to me that I can afford. American Valley Waste Oft hereby advises Ine above Generator that generators shipment of used all may he transported to a faclli thatch r4qulmd to compy,with federal regulations applicable to management of used alt,but that Is not raqutred to comply with the mare stringent raquImme.nIa applicable to hamrdol,Is waste management fact 11- 1les.California fac[lit les that handle or process used oil are required to meal those more stringent requirement,and some out-of-state facilities that process ased oll also rrlsat those taquirements,angtneertng certifications of tank integrity,and financitrt assurances forClosuro and accidental releases.it Is lawful to send tread oil taout of state facilities that eomplyonly with fedora[used Of management standards and not these more stringent requirements. This notification is for information purposes only. By both pattss 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 licensed treatment or transfer facility, r GENERATOR/ 1 DRIVER AUTHORIZED SIGNATURE: DATE: SIGNATURE: r '7�G. i DATE: DISPQSALLRECy-C ING_CA ' L T O DK-DIXON O ASBURY ENVIRONMENTAL RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT 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 209-863-8181 213-746-0237 818-770-2577 EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 r MPC(712016)