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AMERICAN VALLEY 175033 WASTE OIL, INC. Invoice Number: P.O. Box 340 - Delhi, CA 95315 PH, 1-800-732-4645 - FAX 209-668-3880 EPA#CAR000272302 �J.FENOR PAPER F! BILL TO: 4,?01E,FPEb/10NTGT JOB SITE: 4HII hiviDice Date-, STOCK—f CA 95 215 ST0C'X-",0,N,CA K"I"16 Phone 20a-361-8%8 X ustomer P.O. Terms EPA# At,0 00 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 Compliant Drained Used Metal Oil Filters 1, A Z W.M Tf--- Ti C 111 IJP-A F'�.�0F�31 C-N T t)AN,C)(_A 1, L AL) S I A L E S T A X,- TERMS: invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees 11 court action fOl AL becomes irreco6sary to collect this Invoice. By signing I herby certify that I have not mIxed any of the waste described above vilth any othar hazardous waste,the total halide rantent Is LESS than 1,000 ppm,and the waste does not contain any PCBs.I have coniplad with the requirements of the appIlcabe cmiformin used oil management regufaflon to determine this Is true.I alrlr(m to accept the additional charges for the disposal of this waste If the Information I have provided about this Waste Is Incorrect. Se-nerater's By signing I certify that if I am a lorge quanHtygenerator,I cartify that I have a proaram In plAce,to reduce the volume and toxicity of waste gariviral- 'od to Ifiep deg i no I h1vo cin f6rmln 0 to bo eCoJtWft8Jly.11 Ifo ifda big Ono thin I have aelocted Vie practicable irrinThoo of iiommant,storage,or disposal Gi,srraMly avaltablo Io me wh1ul I ritfillpilites tM prnsenl nrirl luturn thttzl to humin lift,and We envirorin,"t-.0j,,it I ane a arnall quantity Q811PHAt0r,f have made a Good fallh effort to minimize my wasto- genartlSlon ivlml the vmilo nw-elawmirt muilhod that is avoibible In Ine[hal t mnItforo. Amer an Valley Wn5teOtl bembyziciv I-ief-I hu above Geneiralor I hot qcrieMots.shlipmnnl.of used oil rnay be Ir2tn,,qxutefl to a fat;llity thatItt reqU I rwJ I u comply with.federal Mutations applicable to.rnaflogament of used ell,bUt VNIT Is not r.oquIred to comply vAlli the more s(fifigont requirernorts applicable to hazwdouq wimau management facill- ilea.Ctilifarnta facilities that handle.ar process titzqd oil am rar.liplrod In meat those inoro stringent requirement,and some out-of-state lacliltea that process used oil also meet those requirements,engineering rartifloallons of lank integrity,and financial am;i Pumices for ulojure and accidental releases.It is Inwful to send used oll to out of state facilities that comply only with federal used oil management standards and not these more stringent iorlulraments. This notification Is for Information purposes only. By both pnllfes slgpllily th!a invoice it will wovo ns An a"Moilt that American Valley Waste 011 will submit confirmation for(certain waste streams)to the generator that their Waste Ras beefs tron.-;pniried to a llcen6ed irowrinent or traftWor fn0lily. GENERATOR/ DRIVER AUTHORIZED SIGNATURE: 'e-'C / DATE- SIGNATURE: DATEf.: DIL I RE MLO L�E�AC LEY -POSA 0 DK-DIXON 0 ASBURY ENVIRONMENTAL 0 RIVERBANK OIL TRANSFER 0 YUMA YES LLC 0 AMERICAN VALLEY WASTE OIL,INC 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD, 6500 US HWY 95 521 INDUSTRIAL DR STE M DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA 95334 707-693.600B 209-541-1825 209.863-8181 928-344-9828 209-667-8857 EPA#CAT080012602 EPA#CAL000393680 EPA#CAL0001 90816 EPA#AZR000521146 EPA#CAL000443004 MPC(7/2016)