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f 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 FLEENOR PAPER CU BILL TO: 4201 E.FREMONT ST JOB SITE: Pt-J�wNOR PAPUR 00 STOCKTON, CA 95215 4201 E.FREMONT ST Invoice Date: Sl'CICKCTON,CA 9521-F Phone 2OR-4101-8593 JC7,SU 'Customer P.O. Terms C 011 EPA# C�L(�0318085 {r 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 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 to collect this invoice. lay slfmirirg I limby carlity that f havA not rnlxad Onyof the waste described ahnvn WI111 Orly other 11 ngA00O In wa6(o,1114 tatol halide content is LESS than 1,000 ppm,and the vinnio do"not ronlain any POB% I have complIod with the fequlremeilte at Ihoapplicable Cr111fontia used all monegernenl regulation to determine this Is true.I agree to accepi thr nddttignal chargrss(QF Ill)dISPvsnl of This waste If the information I have provided abnul thls wnnte to illcvfrect. [irrlHratoes CerlilicalErsn;By 4ignrnt1 I corllry ilial If I am a lrirpe(lunnfily giTnraloi 1 certify that t hrivp it prrudrarn in place to amuoe frig volume and toxicity of wasis rlonarnt- nrf If"the clerjnla I ItMfe rfMV11 10 10 bo eoemornically aftorrlwu End that I have z vIE)rtctd lhn pns:tirable inolhod of 11"Inval,sturnue,or disposal ran-m fitly mailahla Ia ilia rallich mlf9mires Pie Prasoni Arta luturn lanes!1n hurntin 111n an Ihn envIronwvrl1;tar;If 18111 a smoil qunnllty goheotor-I have rnatte a Goad faith iiftorl to minIroIP.e my wattle gerlLinaII17n and.eIor,I ilia wa5to mana41en1pm rtlethorl that k avallat7ie to rile that I nm afford. Ainor1c;m Val toy Waste 011 hof epy arlvlses 1h abatis Gunamtor that penerslora shipment of v*o-d olf may be trail sparled In a rnr:Ilily the I.is required to connply with fr.(Iuill reaulaIions app cable to mrnla(lelnenl a vkd aII,huI that iG not req lilred la cotnpfy vM11 IhR man!sl.rinoont req ulrellwnI,apftffrable la Ii=rdous weatu mnnartomnnt Iaell l- I.Ies.Cal I(Dull R Paul 1111os ilia 111aniilo or process user!all aro wiulred I rnreef 1lfotie:mots stringani ragtitremfint,and some o[it-of•slille facilhles that pfocfmll uged oil ulna meet Ihfiaa ragolran lents,anpineeririq cedificallatin of tank In"IIty,and linsrlalal a"Uralncfig tar closure and accidontat raIoaees.It[s lawful to ncnd.us"I oil 10()qrl a!a,iil(r faCililfas Thai C0111Dly only with ladernl used ail frOnngarmull minorinn;18 grid not These more w0pigant requiremenl6. This notification is for Informatlon purposes only. By both parties signing this invoice it will serve as an agreement that American Valley Waste 011 will submit confirmatlon for(certain waste streams)to the generator that their waste hes been transported to a licensed treatment or transfer facility. GENERATOR/ DRIVER � � AUTHORIZED ( / r SIGNATURE: y. DATE:, f f s:..51GNATE1FIEr DATF� �# Q1SP0_SALLB —C NG FAQ-1-M O DK-DIXON O ASSURY ENVIRONMENTAL RIVERBANK OIL TRANSFER Q CFR Q 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 213-746.02.37 818-770-2577 EPA#CAT080012602 EPA#CAL000393680 EPA#CALOOD190816 EPA#CAL000270577 EPA#CAL000417316 MPC(712016)