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AMERICAN VALLEY 176594 <br /> 1 WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340 - Delhi, CA 95315 <br /> PH, 1-800-732-4645 - FAX 209-668-3880 <br /> EPA# CAR0002t2302 3 <br /> F.V AINLEY EL K. J PIC,MQJ OR(X�) grAl FL5f-.7P1<-'Jk4QTOF4 CO <br /> BILL TO: 15XI 5, NTINVP ate JOB SITE: V;20 E;' NAR IER AVE'- Invoice <br /> Date.. <br /> I Gl,­'. <br /> STOC TON,CA 30205 b'F0GK'K)J 1, t'A 14620t� <br /> f, <br /> Phone 2LtW_Q04_/6 Customer P.O. 4111 S Il L404 E PAAU0, _,jy03 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 gg <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRAWasS Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> OIL COLLIE.C.If 1014 FEE <br /> TERMS: Invoices over 30 Days are subject to a 1.5%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 certify that I have not mixed any of the waste described above with any other hazardous wast? <br /> ,,�the total halide content Is LESS than 1,000 corn,and the <br /> waste does not contain any PCBs,I have complied with the requirements of the applicable California used oll m6nagement 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,if 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 management facili- <br /> ties.California facilities that handle or process used oil are required to meet those more stringent requirement,and some out-of-state facilities that process used oil also meet <br /> those requirements,engineering certifications of tank integrity,and financial assurances for closure and accidental releases.It is lawful to send used oil to out stabile 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 /> 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 <br /> DATE: <br /> AUTHORIZED <br /> SIGNATURE SIGNATURE DATE.' ` <br /> �,� ------- <br /> DISPOSAL / RECYCLING FACILITY <br /> 0 DK-DIXON 0 ASBURY ENVIRONMENTAL (V/RIVERBANK OILTRANSFER 0 YUMAYES LLC 0 AMERICAN VALLEY WASTE OIL,INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIALPR STE M <br /> DIXON,CA 95620 CERES, CA 95358 RIVERBANK, CA 95367 YUMA,AZ 85365 LIVINGSTON,CA95334 <br /> 707-693-6008 209-541-1825 209-863-8181 928-344-9828 209-667-8857 <br /> EPA#CAT080012602 EPA#CAL000393680 <br /> EPA#CAL0001 90816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC(7/2016) <br />