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02/19/2014 PIED 11: 13 PAR E005/010 <br /> SelWPaymentTo: RECEIVE® <br /> 2355 Road 192, Delano CA 93215 <br /> GCo y } <br /> {T YTI r r <br /> Ph : 209-963-0688 - Fax : 209=861-64' <br /> 1� t 11 I EPAECAL01112 21" ID#77.0379490 ENVIRONMENTAL <br /> Job Site : LID.AND INSURED TRANSPORTER a 3465 CA 130615 HEALTH DEPARTMENT <br /> GENERATOR <br /> Site EPA IDN 77 Involce No. jk..:A • <br /> Contact Person '"•''' <br /> Company Name ..., Bill To : <br /> Address N „ Name <br /> Clty,State,Zlp Address <br /> Site Phone ! c' Clty, State,Zip <br /> Date Customer PO .Interval Net 30fC.O.DJCash/Ch11 Drivers TrucklNeme <br /> / EN�C' <br /> PRODUCTcAde CA Manifest# quantity Unita Price Amount <br /> Non-KRA Hazardous WavleUquld(Used 011) 221 Gel <br /> Non-RORA Htusrtbus Wine Uquid(011&Water) '223 Gel <br /> NWCRA HaTerdous Wavle UgJd(Used Automotive Andhaeze) 133 Gal <br /> Non-RCRA HazardousWAOSolids Contaminatad au 1 <br /> Non-RRA—Hazardous Werte SdW Contaminated with Used DI <br /> [rained Used 09 Fidet Onim.(s) lktmtp) <br /> Emply Drum(s) Earn <br /> Tminaporletlon&Ttudc Ila&Washout .. <br /> Hazardous Teadng <br /> we Clatomef Paye <br /> Unlns spec ted en ode Om sdidated Menihet Reaelpt(moos Terms;Aeoowm due m1he l Oth cT the mann fM"rp <br /> rrmnel of purohue:Paha due etxounla will he energetl a FINANCE CHAR E st ns PERIODIC ROTE d 1.576 per meNh whldrl&Me ^re l <br /> PERCENTAGE RATE OF 1616, I If <br /> I hereby certify that I haw d this wapla with any other waste Nat the total halktes am loss than 1000 P.PM;and that Me waste doss net contain / <br /> arty PCP's•I further e*GEBS <br /> the additional charges for legal disposal If this,waste leggy�PPM,t halides,or contains any PCVs <br /> GENERATOR orAUTHORIZED; �a�. DRIVERSIGNATURTERMS:IWOI 8 ARE SU< TI'0A 1.5%SERVICE CHARGE CUSTOMERAGI EED TO ALLLEpALIFEES OF COURT <br /> ACTION BECOMEO COLLE THIS INVOICE, / <br /> Kern 00 hara by advisee thembove Generator that 0enerstore shipment ofuspd di me be tranapormd roe facility that is roquhsd to crimpy whh federal <br /> regulations apppllaable to mannaagpeemtaent of used oil,Rut that Is npi required to comply with the nwce stringentrequirements eppile4ble to hakardats woera <br /> rmneaememhcllldaa:Kam 01(PBtx RaaydinpHauthodzedb Rlea requaetror EPlWfrom DTSC,CeSromkf9etllNat that handle orpro used ollaro <br /> 2 Ined b Mottthoes mtxe ahln�ant requlremente,and cams out-of�tats fgaltltlss diol process used as d also ewettlwae raqulro Ute,engneerinp <br /> eerd0eallone often'Intsprlty and iManclel eseurencea for closure en eceldeMal roleaeee.It Is lawful to earW uead dl to ouFoFstela glides OMt rlompy <br /> ony with federal used all menepemeM standards and not those mora Ston®®ant roqukementa By alpningg the Invdca the peneretor oerWge that nre <br /> generatorhaeeatebllehpd a programto reducetha volumaorquanatyand toxlcly of vita hazaidouswestato the dagres,esdepermined bypeMniOr.to bq <br /> economically practicable. By bash Pardee elonlnp thle Irwolce It will serve ae an apraament that Kern OII wNl submit confsmetiaw k�(aMaln wsets <br /> abeam')['the panwrerortrtgtthakwaptahas[man Vanapartad to a Ilcanced traatmenloriranararracllly, <br /> Riverbank 011 Transfer NAME - NAME <br /> 8300 Claus Rd,Bldg 11 ADDRESS ADDRESS <br /> "rbank,CA 05387. - CITY CITY <br /> Ph:209.888-0888 Fax:200,053.0687 STATE,ZIP STATE,ZIP.. <br /> SPAN CAL000103815 PHONE PHONE <br /> EPA 10 EPA ID. <br />