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r. <br />BILL TO: <br />AMERICAN VALLEY <br />WASTE OIL, INC$ <br />P. O. Box 340 • Delhi, CA 95315 <br />P1. 1=800-732-4645 9 FAX 209-668-3880 <br />EPA# CAL000827878 <br />12.381 <br />Invoice Number: <br />L <br />JOB SITE: vo a i 0�lJZ,r\Jhvoice Date: <br />X01 Lo <br />Lcji <br />Phone ` <br />Customer P.O. <br />Terms <br />EPA# <br />PRODUCT SHIPPING DESCRIPTION <br />MANIFEST <br />QUANTITY <br />PRICE <br />AMOUNT <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />c) <br />OU�I� S�1f ���� <br />Lo <br />Zwq <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 />r <br />TERMS: Invoices over 30 Days are subject to a 1.5% service charge. Customer agrees to pay all legal fees if court actio <br />TOTAL <br />I U <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 waste, the total halide cohtent is(VESS t <br />an, ,00 ppm; -- <br />and the waste does not contain any PCBs. I have complied with the requirements of the applicable California used oil management reguiatiori to de <br />i thiis,/ <br />true. I agree to 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 <br />toxicity of waste <br />generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment, storage, or <br />disposal currently <br />available to me 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 <br />effort to minimize my waste generation and select the waste management method that is available to me that I can afford. <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) <br />to the generator <br />that their waste has been transported to a licensed treatment or transfer facility. <br />r <br />GENERATOR/ <br />DRIVER AUTHORIZED <br />/ <br />SIGNATURE: / '-- -� DAT E SIGNATURE. DATE:' <br />r r <br />DISPOSAL I RECYCLING FACILITY <br />OC DK.DIXON O CFR O UNITED ENTERPRISES CORP <br />7300 CHEVRON WAY 2035 E. 15TH ST. 11190 PENROSE ST. <br />DIXON, CA 95620 LA, CA 90021 SUN VALLEY, CA 91352 <br />707-693-6008 213-746.0237 818-787-2649 <br />EPA# CAT080012602 EPA# CAL000270577 EPA# CAL000379059 <br />MPC (Bl2013) <br />