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-u CD L <br /> = 1 O W <br /> W O N) <br /> 0 K) Z <br /> OW C) <br /> m cno <br /> o o E <br /> U) Z5 Z5 rn <br /> AMERICAN VALLEY o <br /> WASTE SIL, INC. a `< <br /> Invoice Number: <br /> P.O.Box 340•Delhi,CA 95315 <br /> PH. 1-800-732-4645•FAX 209-668-3880 a� <br /> **����� EPA#CAR000272302 W <br /> 'ARvrrr(USTUAM1S <br /> • BILL TO: 1163 VICKSBURG Pi. W <br /> 81 OCKTON,CA 95207 JOB SITE: <br /> (D. <br /> Invoice Date: cn <br /> 0 <br /> Phone U,:i, <br /> Customer P.O. Terms EPA# (D <br /> PRODUCT SHIPPING DESCRIPTION <br /> WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> F <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> t� <br /> z <br /> i <br /> i AJC <br /> TERMS: Invoices over 30 Days are subject to-a1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL <br /> becomes necessary to collect this invoice. <br /> By signing I herby certily 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 ppm,and the <br /> waste does not contain any PCBs.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree to <br /> accept the additional charges for the disposal of this waste if the information I have provided about this waste is incorrect. <br /> Generator's Certification:By signing I certify that if I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generat- <br /> ed to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently available to me <br /> which minimizes the present and future threat to human life and the environment:Or,8 I am a small quantity generator,I have made a Good faith effort to minimize my waste <br /> generation and select the waste management method that is available to me that I can afford. <br /> American Valley Waste Oil hereby advises the above Generator that generators shipment of used oil may be transported to a facility that is required to comply with federal <br /> regulations applicable to management of used oil.but that is not required to comply with the more stringent requirements applicable to hazardous waste managemem facili- <br /> _ ties.California facilities that handle or process used oil are required to meet those more stringent requirement.and some out-oi-state facilities that process used oil also meet <br /> thoserequirements,engineering certifications of tank integrity.and financial assurances for closure and accidental releases.It is lawful to send used oil to out of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <br /> This notification is for information purposes only. <br /> /1 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 <br /> waste has been transported to a licensed treatment or transfer facility. <br /> GENERATOR/ <br /> DRIVER AUTHORIZED DATE: <br /> Illi SIGNATURE DATE: SIGNATURE. <br /> DISPOSAL/RECYCLING FACILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL <br /> ' <br /> 2035 E.15TH ST. 1640 N.BROADWAY <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. STOCKTON,CA 95205 <br /> DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 LA,CA 90021 818-770-2577 <br /> 209-863-8181 213-746-0237 <br /> 707-693-6008 209-541-1825 EPA#CAL000270577 EPA#CAL000417316 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 <br /> MPC I�i20151 <br /> I � <br /> •- O <br /> a <br /> W <br /> O C> <br /> (-n <br /> N <br />