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06,/ 11 / 2021 1 : 40 PM , FAX 2099488625 AMCE SAW 121 0008 / 0908
<br /> AMERICAN VALLEY 17985178
<br /> WASTE OIL , INC . Invoice Number :
<br /> P. Q . Box 340 • Delhi , CA 95S1 5
<br /> PW . 1 "$00-732-4645 FAX 209-668"3880 • , "
<br /> . ' EPA# CAR000272302
<br /> SILL TO: ,.:�';-�. • • • ..-r.:;
<br /> R�Kllr. Asnr JOB SITE: AC{
<br /> i nip , PA'R.1144 ��� �= .�V�f IriV41C� Date :
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<br /> �. � ed
<br /> maTl;��t� K T C„ a , i
<br /> STI:?C14K ? i .11 CPA Intl
<br /> Phone' 116Uustomer FO, ' Terms EPA# Alb+artK Itil9
<br /> ZQ $ 1 - 1e17 JC7t�l�l
<br /> I .le. t 30 Days
<br /> PFiQDUCT SHIPPING DESCRIPTION MANIFEST QUANTITY PRICE AMOUNT
<br /> WANE
<br /> CODE
<br /> IKON" RGRA 'Waste Liquid Used Oil/Mixed Oils 221 Jost
<br /> t'', CD r+ '
<br /> IQN= RGRA Waste Liquid Used Antifreeze 133
<br /> NON-R'CRA Waste .Liquid Used Oily Water 223
<br /> Compllant 'Drained Used Metal ' Oil Filters
<br /> it
<br /> OIL COULEC CION FE 14
<br /> It 4
<br /> I I It 14
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<br /> TERMS : : invoices over 30 Days are subject to a 1 .50 service charge, ' Customer agrees to pay all legal fees If court action14, w:rs •t :
<br /> becomes nedessaryta :colieot this Invaica. TOTAL
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<br /> By;signing I, herby certlfy that) have not mixed any of the waste described above With any, other hazardous waste, the total halide.cantent• is LESS than 1 ,000 ppm, and the
<br /> Waste .do'es 'nOt 'contein any PCB 's.• ) have. complied Wlth the .requirements of the appllc&e Californla' used oil menagemont 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 Gbrtification; By signing I certify that if.l am a large quantity generator, I certify that I have a program in place to reduce the volume aqd toxicity o wasts:gerierat-
<br /> ed to •the degree) have determined to, be economically affordable end. that I have selected the practleabla mettrod Of treatment, storage, or disposal curiantl> available to me
<br /> which minimizes the present and future thrreat to human life and the environment, 40r, if I am a small quantity geherator, I have made a Good; faith 6 minimiza 'my waste
<br /> generation and, Baleat the waster management method that is available to me that I earl afford.
<br /> Am4rioan Valley Waste Oil hereby advises the above Generator that generators shipment of used oil maytransported to a facilit that, ia '
<br /> regv) tI n applicable to management of Used oil, but that is not re UiYed to com I With ,the more strip entre ulretnents a y required to comply wlth 'fecleral
<br /> q p Y . g q pPI Mable tf hazardous Waste management facili-
<br />( ties: ralffomia facilities that handle or prpC6ss used oll 'are required to meet these htpra stringent rgquirement, and s4Yfia out-of--state faci z as that process used 011 also meet
<br /> th'oaa 'requirenlents,.ang!neerIng certific4 At of tank Integrity, and financial assuren es tot Closure and acoidantal releasor, Itis lawful tG sand used o!1 to out of state faciles
<br /> that compfy,only wit(5 federal used oil management atandards• and nofahese mbi m• if ngant,requirementa.
<br /> Thls notification is for information purpprea only.
<br /> By both partios signing this invoice it will serve as an agreement that American Vail$ylNasta Oil will submit confim�atlotl for (certain Waste ms jp.tne generator that their
<br /> waste has bee4 transported to a lfoonsed tilealftnt or transferfacility. -
<br /> DRIVER - AUTHORIZED
<br /> SIGNATURE: ` DATA;,.? 1 ,, SIGNATURE: j
<br /> ss 1DA7E ,,•r _
<br /> DISPC7SAL I RECYCLING EA ILITY
<br /> 11 DK-DIXON ASRURY• ENVIRONMHNTAL O RIVERBANK OIL TRANSFER O YUMA YES LLC; 0 AMERICAN VALLEY WASTE CIL, we
<br /> It 0 ,7300 CHEVRON WAY 1920 MORGAN RD, 5300 CLAUS .RD, 6500 US MWY 95 821 INDUSTRIAL DR STEM '
<br /> DIXOR CA 95520 CERES, CAA 95358 RIVERBANK, CA 95367 YUMA, AZ 85365 LivtNGSTON , CA'95334 '
<br /> ` 707-`693'x'6008 1209-541AS26 '1 . 209-863-8181 , ' 928.344.9828 209667-8667 .
<br /> EPA# CPAT080012602 EPA# CAL000393680 " EPA# GAL000190816 EPA# AZRp00521146 . 1 PA# CAL0004d3004
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<br />`r MPG (712016)
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