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p AMERICAN VALLEY 19 6 4 7 2 WASTE OIL, INC. Invoice Number: P.O. Box 340 • Delhi, CA 95315 PH. 1-840-732-4545 • FAX 299-668-3889 EPA# CAR000272302 BILL TO: JOB SITE: Invoice Date: Phone ; -,�.� Customer P.O. Terms EPA# PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT CODE NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 NON-RCRA Waste Liquid Used Antifreeze 133 NON-RCRA Waste Liquid Used Oily Water 223 Compliant Drained Used Metal Oil Fifters r. I I TERMS Invoices over 30 Days are subject to a 1.5 service charge Customer agrees to pay all legal fees it court action TOTAL becomes necessary to collect this Invoice- By signing I herby certify that I have riot mixed any of tie waste descrrbad above with any other hazardous waste,the total halide content Is LESS than 1,000 ppm,and the waste does not contain any PCBs.I ha%ie complied with the requirements of the applk able California used oil management regulation to determine this is true-I agree to accept the additional charges for the disposal of this waste it the information€have provided about fhss waste is inoorrect- Generators Certif+catK3S.By signing I certify that It I am a large quarrfity generator.I certify that I have a program in place to reduce the volume and toxicity of waste generat- ad to the degree I have determined to be economica€fy affordable and that I have selected the practicable method of treatment,stOrage.or disposal currently available to me which rriinlm¢es the present and tufure threat to human life and the environment:Or,if 1 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 avallab€e 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 regulations applicable to management of used Oil,but that is not required to comply with the more stringent requirements applicable to hazardous waste management facill- ties California facilities that handle or process used ad are required to meet those more stringent requirement,and some out-of-state facilities that process used oil also meet those requirements,engineering certrticavons of tank integrity,and financial assurances for closure and accidental releases.It is lawful to send used oil to out of state facilities ttnat comply only with federal used oil management standards and not these more stringent requirements. This notHication Is for information purposes only. By hath parties signing€his invoice it will serve as an agreement that American.Valley Waste Oil will submit confirmation for(certain waste streams)to the generator that their waste has been transported to a licensed treatment nr transfer facilrly. GENERATGRI OR€VER AUTHORIZED SIGNATURE-- GATE SIGNATURE. DATE: DISPQSAL 1_RECYCLING FACILITY Q DK-DIXON D ASBURY ENVIRONMENTAL Q RIVERBANK OIL TRANSFER Q YUMA YES LLC Q AMERICAN VALLEY WASTE OIL INC, 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STE M DIXON. CA 95626 CERES.CA 95358 RIVERBANK. CA 95367 YUMA,AZ 85365 LIVINGSTON.CA 95334 707-693-6048 249-541-1825 209-863-8181 928-344-9828 209-667-8857 EPA#CAT080012602 EPA#CAL000393680 EPA#CALO00190816 EPA#AZR000521146 EPA#CAL000443004 MPS{7:2C1Fi1