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BILL TO: - <br />AMERICAN VALLEY <br />WASTE OIL, INC. <br />P.O. Box 340 •DV CA 95315 <br />PH. 1-800-732-4645 • FAX 209=668-3880 <br />EPA# CAR000272302 <br />JOB SITE: r. <br />YcL <br />159IJ6 <br />Invoice Number: <br />Invoice Date: <br />Phone Customer P.O. ITerms EPA# I <br />MPC U1201 <br />, :riF•RL' .,_,... _.. I_ IAIQ(1vr4y6Pi <br />i <br />��..-, , _ __ <br />MANIFEST QUANTITY PRICE <br />J`ttttAMOUNT <br />PRODUCT SHIPPING DESCRIPTION WASTE I <br />CODE <br />00 <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />133 <br />NON-RCRA Waste Liquid Used Oily Water ( <br />223 <br />Drained Used Oil Filters <br />L 1 tCEnn T <br />i <br />I <br />I I <br />I <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. Customer agrees to pay all legal fees if court action I TOTAL <br />becomes necessary to collect this invoice. <br />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 then 1,000 ppm. and the <br />By determine this is true. I agree to <br />signing ble Cifornia ed oil manaement regulation to <br />does contain any wilh the lrements of <br />ehnm <br />awaste this waste s incorrect, <br />L"pl thea additional chargesCfor the d spoaal off this waste it heinforrmationlhe I havepprroo provided <br />Generatora Certification: By signing I certify that if I am a large quantity generator, I certify that (have a program In place to reduce the volume and toxicity of waste general& <br />the method of treatment, storage, or disposal currently available to me <br />ad to the degree I have determined to be economically affordable and that I have selected practicable <br />Or, it 1 a small generator, I have made a Good faith effort to minimize my waste <br />which minimizes the present and future threat to human life and the environment: am quantity <br />generation and select the waste management method that is available to me that 1 can afford. <br />Is withfed <br />be transported to a faccilit to co <br />fral <br />American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may <br />is to comply v,dh the more stringent requirements app iletlo hezurdoued mpoa <br />regulations applicable to management of used oil, but that not required <br />those more stringent requirement, and some out-of•state facilities that process used oil also meet <br />ties. California facilities that handle or process used oil are required to meet <br />financial assurances for closure and accidental releases. It is lawful to send used oil to out of stale facilities <br />those requirements, engineering certifications of tank integrity, and <br />federal oil management standards and not these more stringent requirements. <br />that comply only with used <br />This notification is for information purposes only. <br />it as an agreement that American Valley Waste Oil will submit confirmation for (certain waste streams) to the generator that [heir II <br />By both parties signing this invoice will serve <br />waste has b in transported to a licensed treatment or transfer facility. <br />GENERATORI <br />^7AUTHORIZED DATE: bI�, I <br />DRIVER ' DATJ I SIGNATURE: <br />E• � <br />_-- <br />SIGNAT OR - <br />L I FACILITY <br />O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br />DK-DIXON <br />1920 MORGAN RD, 5300 CLAUS RD, 2035 E. 15TH ST. 1640 N. BROADWAY <br />7300 CHEVRON WAY <br />RIVERBANK, CA95367 LA, CA 90021 STOCKTON, CA 95205 <br />DIXON, CA 95620 CERES, CA 95358 <br />209.863-8181 213.746.0237 818.770.2577 <br />707-693.6008 209.541.1825 <br />EPA# CAL000190816 EPA# CAL000270577 EPA# CAL000417316 <br />EPA# CAT080012602 EPA# CAL000393680 <br />