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y . AMEkICAN VALLEY 175553 WASTE OIL, INC. Invoice Number: 1 P.D. Box 340'o Delhi., CA 95315 PH. 1-800-732-4645 a FAX 209.668-3880 EPA#CAR000272302 ME AUTO REPAIR MOE AUTO REPAIR 7 ./.f d f,. 4' BILL TO: 2265 S.AfRPORT WAY JOB SITE: 2266 S.AIRPORT WAY Invoice Date: Sii"OCKTOhl, CA 9"5206 STOCI�`Ol�f,CA 95206 • �alr��tl�: A�>`1�ItV�lI�Y Phone Customer. P.O.. TermsEPA# CAL000381071 PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT CODE NON-RCRAWaste Liquid Used Oil/Mixed Oils 221 NON-"RC.RA,Waste Liquid Used Antifreeze 133 ii NON-RCRA Waste Liquid Used Oily Water 223 Compliant'Drainad Used Metal Oil Filters 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 S• r becomes necessary,to collect this invoice. By signing l herby certify that I:have not mixed,any of'the,waste�described above with any other hazardous waste;the total halide coritent'is LESS then 1,000 ppm,.and,the ,waste"does.not contaln any PCBs.I have compiled with the•requlrements�of the applicable California use6 oil management regulation•to determine this is true.I agree to accept-the.additional charges for the disposal of this waste If the,Information I have:provided`abouttltis wastels incorrect. Generator's Certification:By'signing:I certify that if I am.a large quantity,generator,.t certify their I have a"prcgram ln.piace to reduce the volume and toxlclty of waste generat- + ed,to the:degree 1 have determined•to be economically affordable and that-1 have selected the practicable method of treatment',storage,-or'dlsposal.currentty aVailabte tome which minimizes the,present and future threat#o:liuman life and the environment,Or,if I amiasmail quantity generator,I have-made a Good"-faith effort to minimize my waste ,generation and select tho waste management method that is available.-to me-that I can afford. American Valley`Waste bitthereby advises the above.Gencratorthat>generators,shipment cf used,oll may be transported to a.facility,that.is-required to comply withtfederal regulations applicable-to.management of used oil,but that isnot required to comply with the more stringent-requirements,applicable to,hazardous waste Management.facill- ties..Catifornia'facilities that handle or:prncess used oil are,required to meet those,morestdrngent requirement,and some out-of-state facilities.that.process.used oil alsoisneet biose requirements,engineering certifications of tank-integrity,.and,financial assurances for•closutb and adcidentat•reieases.It is.iawful to send�used oitto out of state facilities that.cornply only"with federal!used oil-management standards and-riot these more stringent requirements. This notification is for information purposes drily.. By both parties signing•this.invoicelit will serve.as,an agreement that American Valley Waste Oiliwill'..submit,confirmation fore(certain waste"streams)to the•generator that their waste has been'transpgrted:to.a licensed�treatment or lransfer4qcility. "GENERATOR/ DRIVER AUTHORIZED -------` — SIGNATURE: DATE: �j SIGNATURE. " � DAlE��f/�� I DISPOSAL 1 RECYCLING EACI:LITY �7 O DK-DIXON O ASBURYENVIRONMENTAL. O' RIVERBANKOILTRANSFER O YUMAYES'LLC O AMERICAN VALLEY wnsTECAL,INC 7300 CHEVROWWAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 iNDUSTRIAL.DR STEM DIXON,GA 95620 CEiES,-CA 95358. RIVERBANK,, CA 95367 YUMA,AZ 85365 :LIVINGSTON,CA 95334 707-693-6008 209-541-1825 209-863-8181 92&3447=9828 209.667-8857 EPA#CAT080012602 -EPA#"CAL000393680 EPA#CAL000T90816 EPA#AZFi000521146 EPA#CAL000443004. y r Mpe°;712016j 4 ..