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26 N. Cherokee Ln, Lodi, CA 95240 Record ID PRO540266 <br /> 10/14/2016 PHOTO #2 <br /> 2015 Manifest with incorrect State ID number <br /> Send Payment To: <br /> f .. <br /> 2355 Road 192, Delano C <br /> Site : Ph : 209-863-0888 - Fax : 209-863-0887 <br /> Job S11@ EPA#CAL000367042 I D#46-0727047 <br /> LIC.AND IN SURED TRANSPORTER#3466 <br /> GENERATOR MCP#CA 130615 <br /> Site EPA ID# <br /> 000 Contact Person Invoice No.M., <br /> Company Name Bill To : <br /> Address <br /> Name <br /> City, State, Zip Address <br /> Site Phone City,State,Zip <br /> Date Customer PO Interval Net 30/C.O.D./Cash/Check Drivers Truck/Name <br /> /, <br /> PRODUCT Waste CA Manifest# Quantity Units Price Amount <br /> Code <br /> Nan-RCRA Hazardous Waste Liquid(Used Oil) 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) <br /> 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal pna l i <br /> Non-RCRA Hazardous Waste Solids Contaminated psi <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil <br /> Orumsjsl � <br /> pralned Used Oil Filter Drum(s) Eau <br /> Empty Drum(s) HR <br /> Transportation&Truck Time&Washout <br /> Hazardous Testing <br /> We pay ❑ Customer Pays Total <br /> Urns otl+erw'Ise specified on Nis Consolidated Mantled Receipt(Invoice)Tonna:Accounts due on the 10th of the month lollowmt3 <br /> Wrchasa P851AGE RATE OF due is Iii be charged a FINANCE CHARGE at the PERIODIC RATE of 16%per month,which is the <br /> ANNUAL rcr.CEnot <br /> celdh'that I have not mixed this waste with any other waste that she total .waste are leas than 1DUa PPtAhand that t waste <br /> tis anydo" <br /> CB's main <br /> or agree to accept the additional charges far legal disposal It this,waste Is over <br /> or '� DRIVER SIGNATURE <br /> Fatinah Zareef, REHS Page 2 of 6 <br />