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210 S Sacramento St, Lodi, CA 95240 PRO514307 12/07/2021 Program: HW PHOTO 5: 11/30/2021 consolidated manifest receipt for used oil has an incorrect EPA ID number ;498 �wnber: • �- AMERICAN VALLIEY 195497 WASTE OIL, INC. Invoice Number: / \h "P.O.Box 340•Delhi,CA 95315 )ate: PH.1-800-732-4645•FAX 209-668-3880 �atc°. EPA#CAR000272302 BILL TO: AI1TO&Iax11AUbT f�k06 I t- It)—a' 210 0ACRAPMNTOST JOBSITE- Al!!p 6 EXHAU6T PROS Invoice Date: LOODI.CA Q 210 GACRANENTO ST OPENS AT&30 LODI,CA IUNT Phone 208.988-4056 JESUS Customer P.O. Terms EPA# C.O.D. CAL000241807 WASTE PRODUCT SHIPPING DESCRIPTION MANIFEST QUANTITY PRICE AMOUNT �S r CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 J 1 NON-RCRA Waste Liquid Used Oily Water 223 Compliant Drained Used Metal Oil Filters OIL COLLECTION FEE OWCS.UU • ; z • ' 1 TERMS: Invoices over 30 Days are subject to a 1.5%service charge. Customer agrees to pay all legal fees if court action TOTAL becomes necessary to collect this invoice. Bysigning I herby certify that I have not mixed any of the waste described above with any other hazadous waste,the total halide content is LESS than 1,000 ppm,andel the 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 accept the additional charges for the disposal of this waste if the information I have provitled about this waste is incorrect. Generator's Certification:By signing I certify that if I am a large quantity ad to the degree I have determined to be economically affordable and atrI have rse selected the tpracticable method ofrogram in ltreatm ace to nt.storage,uce the or disposal cume and urrently tof wastely available o me I 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 generation and select the waste management method that is available to me that I can afford. 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 1 regulations applicable to management of used oil,but that is not required to comply with the more stringent requirements applicable to hazadous waste management facili- 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 those requirements,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 that comply only with federal used oil management standards and not these more stringent requirements. This notification Is for information purposes only. By both parties signing this Invoice it will serve as an agreement that American Valley Waste Oil will submit confi tion for(certain waste streams)to the generator that their waste has been transported to a licensed treatment or transfer facility. DRIVER � GENERATOR/ AUTHORIZED SIGNATURE: DATE_lli SIGNATURE: DATE;# DISPOSAL IRE Y N FA I I OON 7300300 C SBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER Q YUMA YES LLC CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. �AMERICAN VALLEY wnsrE olL,INC DIXON,CA 95620 CERES,CA 95358 RIVERBANK, CA 95367 YUMA,AZ 5365 L VI GSTON 95 521 1CA9 334AL DR E M ,r 707.693-6008 209-541-1825 209-863-8181 928.344-9828 209-667-8857 EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 VICKY VANG-LEE, REHS Page 5 of 5