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AMERICAN VALLEY 17 0 7 P I WASTE OIL, INC. Invoice Number: P.O. Box 340 - Delhi, CA 95315 PH. 1-800-732-4645 - FAX 209-668-3880 EPA# CAR000272302 FLFEW)R PAI-,E-,R a) FLEENOR PAPER CC) BILL TO: 4201 E.FREMONT 5F JOB SITE: 4201 E FREMONT ST 111voke Date: STO(-KTON,CA 95215 `a'TOCKIONI, CA 05215 2008;3119 lltm--M)-A-1�1-"— sajes�ftp' Phone Customer P.O. ITerms C 0.13 EPA# CAL000318085 A PRODUCT SHIPPING DESCRIPTION WASTE MANIFOt 1 EST uAlm'll'IT' PRICE AMOUNT CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 .,NON-RCRA Waste Liquid d Used Oily Water 223 Drained Used Oil Filters 7' -it.41t, P f 64 go 4 &!Zt4l. SALES 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 that I have not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than 1,000 7m,dwt"'� waale dons not contain any PCElr.I have complied with the requirements of the appilosi)[o California used oil management regulation to determine this is true.I agree to ar.capt the addlMonal charges for the disposal of this waste if the information I have provld(-,d about this waste Is incorrocl. Generalar's.Certipoatfon:By!Ilprnlrlq Icerfily 11gri it larn a 1w(y.-ctimmity generator,I cartily that I have a program In place to reduce lhe volume and toxicity ofwasle generat- ed to the degree I have daletimplod 10 NW+ ilpllnlcally effurdf.lble antJ that I have selarted the praclir.Ablo rneil1od of treatment,storage,or disposal currently avaftble ktgrpia wh;01 ral n[mizea I ho present and Mum I hreat to human life and 1he environment:Or,if I am a 8m-ai I quantity generator,I have f1wd LA a Good fal ih effort to min im4a my Wa sto generation and select the waste management method that is available to me that I can afford, Arriorl"n Vatiny Wa9te oil hqroby advisas,the above(0oaralor lhat qennwors shlpmcnt of used all may he Ironno. rted to a facility that Is requited if)comply with federal nqqqlMons a p pi tcalblo IQ m anage mont Of resod oli,but that in not requi nra 10 ro nly w[I h the more n h in go n I tm u in)man is appi ca bie to ti azardous vvw8 tt141nogement fa niii- INS.C13 1 ifor rl IAI fitc,liflos 1 MI dandle Of PrMOSS L0 Dd all nee roqo I rod IQ I no c t thcj3w mora mrin ge.ri t recitilre in ml,and qoma o u I�of-w art faci[I tles that procen-i used all 9 3o meal those requIre m 60m,engineering cc rtlIIc atlons of rank frileg rl ty.and C n ancl ftl asaLlrar rrp.n for cloeuto and nec I de ni Al Ff'.lt'.AGOS,It ir;lawful to send used all to out of slate faci 111 lea That comply on ly wil IN federal used ol I ma rag orne rh I An rids rds and not these more at rinoo-n I rt-qvire m Onto. 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 confirmation for(certain waste streams)to the generator that their waste has been Iran;ricawd to a licensed treatment or transfer facility. DRIVE GENERATOR/ DATE: AUTHORIZED DATE:SIGNATURE: D1 -Z�tK�C-L MAGUT-y- 0 DK-DIXON 0 ASBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 CFR 0 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#CATOB001 2602 EPA#CAL000393680 EPA#CAL0001 90818 EPA#CAL000270577 EPA#CAL000417316 L - -I MPC(7/2016)