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: AMERICAN VALLEY <br /> 179174 <br /> 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# CAR000272302 <br /> BILL TO: VAZ fi,UCkING JOB SITE: 4,Z TRUC.."G Invoice Date: <br /> 4740 E Pd TIER x740 E. PELTIER <br /> ACAMPO, CA 952 ACAMPO. CA 95220 <br /> 2M OIL <br /> Phone Customer P.O. Terms EPA# AmilIl Va ill <br /> 2Ct�3�J�4-9(1G+1 JZ lA� <br /> Not OW: CAL00005: <br /> PRODUCT SHIPPI VG DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Compliant Drained Used Metal Oil Filters <br /> OIL COLLECTION FEE <br /> TERMS: Invoices over 30 Days are subject to a 1,5co 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 waste.the total halide content is LESS than 1.000 ppm,and the <br /> 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 <br /> accept the additional changes for the disposal of this waste if the information I have provided about this waste is incorrect. <br /> Generators 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 thet 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 of state facilities <br /> that comply only with fede,al 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 AUTHORIZED <br /> SIGNATURE: DATE.' SIGNATURE DATE:/— <br /> DISPOSAL / <br /> ATE:,DISPOSAL / RECYCLING FACILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O YUMA YES LLC O AMERICAN VALLEY WASTE OIL INC <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. 6500 US HWY 95 521 INDUSTRIAL DR STEM <br /> DIXON,CA 95620 CERES.CA 95358 RIVERBANK. CA 95367 YUMA.AZ 85365 LIVINGSTON,CA 95334 <br /> 707-693-6008 209-541-1825 209-863-8181 928-344-9828 209-667-8857 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#AZR000521146 EPA#CAL000443004 <br /> MPC(712016) <br />