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Phone Customer P.O. Terms FPA4` <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST IQUA:v71-y'i PRICE AMOUNT <br /> f CODE <br /> I 1 <br /> NOIN-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 , f_ <br /> NON-RCRA Waste Liquid Used Oily Water 223 := <br /> r _ <br /> Compliant Drained Used Metal Oil Filters <br /> — r <br /> 1f1 ., _t f. 11ilIN ..�$_ <br /> I I <br /> I <br /> I <br /> TERMS Invoices over 30 Da7;s are subject to a 1,S%service charge. Customer agrees to pay a+i legal fees if coup anon TOTAL <br /> becomes necessarytd coiled his invoire- <br /> By.sign ng I herby certify that I have not mixed any of the waste described above with any other hazardous waste,the total balioe content is LESS than 1 000 ppol,and',r, <br /> waste does not contain any PCBs.I have comp:ied with the requirements o`,the applicable California used oil management regulation to determine this is true I a�ree to <br /> accept the additional charges for the disposal of this waste if the inferma:ion I have provided about this waste is incorrect. <br /> Generator's Cortifrcation'By gIgning;I certify that if I am a large quantity gererator.I certify that I have a program`:n pace to reduce the volume and toxicity o1:Taste <br /> edto the degree I havedeterrntned 10 be,economically affordable and that I have selected the practir.able,method of treatment,storage,or disposal r-irre.ivy ava:lab,e t: r <br /> whjich minimises the present and suture threat to human life and the environment:Or,it I am a small quantity generator, have made a mord faith effort to minimize nv wa<<F <br /> generation and select the waste management method that is available to me that I can afford. <br /> Art m? zn Va!!ey Waste Oil he-reby ad-Asps thz above Cerler=t,MW.gonera;om mpmw_1t Of 11-14d sal My be!nrLSA)rtM td a[aril;y that s Muirad tC comply with tzde-,a+ <br /> regulal!ons appllbabls tri management of used oil,out that s not requ+md to comply with tate more stdril ma,uirements appiic:.bW to ne.�rdotes waste rceWWW-want fa:r. <br /> ties.CZlifrtmiy faciSitleB that ha-die or prn.,,cess uto£ ati am required 10 meg:!hose more%strtrlgert rBQ:irernent.an6 some out-W..-stalefa iTG95 that process used rmi all.mnw <br /> thdfefc+quirtametls,engineering certiflcatror--of tank inlegr}ty,and financial assurances for closure and accidental releases It is lawul tc send a.ed oil to eli'of sate <br /> that ccn:aly ofrltl with federal used til maneaerne.nt standards and not these more stringent requirements. <br /> This notification is for Information purposes only. <br /> By both partes signing this invoice it will serve as an agreement that American Valley Waste Oil wily submit ronfirrnavon for(certain waste streams)to the ener!t 7r that their <br /> wgs a has been'ransported to a licensed treatment or transfer facility. <br /> GENERATOR! <br /> DRIVER AUTHORIZED <br /> SIGNATURE: DATE: SIGNATURE: DAT E <br /> IDISPOSAL 1 RECYCLING FACILITY <br /> Q DK-BIXON O ASBURY ENVIRONMENTAL QVRIVERBANK OIL TRANSFER YUMA YES LLC �h+E•t:A Lh - <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL UP STE t,11 <br /> DIXON.CA 95520 CERES,CA 95358 RIVERBANK, CA95367 YUMA AZ 85365 LIVINGSTON,CA 9533.1 <br /> 7�i;-S93-Gt708 209-541-1825 209-863-8181 928-344-9828 209-667-8857 <br /> EPA#CAT060012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL0004,1300 I <br />