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02)19/2016 WED 11: 13 FAX R ®006/010 <br /> ECEIVEL <br /> Send Payment To: F'3 19 ?.1:4 <br /> 2355 Road 192, Delano CA 93215 <br /> I 4QWENTAL <br /> iii i rn r r <br /> Ph : 2D9 883 0888 - Fax RTMENT <br /> LL�:.LLI.0 EPAeCA000398163 ID# 77-0379490 <br /> Job Site ; LIC.AND INeUREDTRAN6PORTERP3160 CA 130815 <br /> GENERATOR <br /> SNe EPA ID# C ;ate or�r r 2 7r Invplce No, <br /> Contact Person -Y %N <br /> Company Name ill To : <br /> Address / --- -7' , A• r' Name <br /> City,State,Zip ; , - �,1 Address <br /> Site Phone Z .q !J - ' r , City,State,Zip <br /> Date // //1 Customer PO Interval 1 Net 30/C.O.DJCsshlCheck Drivers TrugklName <br /> PRODUCT wade CA Manifest# Quantity Un Prkm Amount <br /> Non-RCRA Hazardous Waste Lould(Used Ou) 221 Gal <br /> Nan-RCRA Hazardous Wallis Uqukt(01 B Water) 223 Gal <br /> Non-RCRA Hazardous West Uquld(Used Aubn*ieAnftze) 133 Gel <br /> Nan-RCRA Hazerdim Weare 5dids Contamktatad itt,") <br /> NORCRA Hazardous Waste Stich CtIntamlrated with Used Oil3F 12 <br /> vozoa $936uF .J <br /> Grained Used 011 Fluter Drum(s) -O SNI Olt <br /> Empy Drum(s) Ed 0 r J <br /> Trsnaporistlon llTruck alma&wamw IR <br /> Hazardous Testing <br /> We pay L1 Customer , . <br /> Unless othemin spnBb on WoComethali Menhot Receipt Pinola)Terms:Acaonte dw on Im 19h of the month fallowing <br /> month or pulcnen,Peet dw aa000mr will he cherpatl a FINANCE CHARGE aline PERIODIC RATA or 1J3%per Imnm,Wrdah le the <br /> ANNUAL PERCENTAGE RATE OF 10%. <br /> I hereby certify that I have not fnb d this yvEf 'Hh any other waste that the total halides ark,one than 1000 PPM;and that Me wulia&i s not owtoln <br /> any FCB'a I What sum.3ep pt the sad nal chargee for lapel disposal a thle,"ell Ts over/00 P,M,fetal Mea,a oa tdns <br /> riENBRATOR or - r ) <br /> AUTHORIZED: r-✓/f DRIVERSIGNAT <br /> TERMS:INVOICE8 R 60 DAYS A BJECT TO A 1,6%8ERVICE CHARGE CU. R AGREED TO RA LEO EES OF COURT <br /> ACTION SECOMrd'NECEASARY T Co ECT THIS INVOICE <br /> Kom04hembyadvisestheabove0onerotorthatGeneratorsshipmentofusddoilm be transported to afacllityth to comply with federal <br /> reauletlon6eppllcabfatome ' amentof4aedall.ButlhatIsrotrequbaltooangywl DwmaraWrinasntrequlrem9 bit to hazm*us waste <br /> mmegsmerd leaks,ICemOe Fliter Recycling is authwhoird to the a request for PA#from DTSC.CeIUomlafegatieattat ndletnpmcges used Wlsm <br /> required to meet those more ebinpant rgqulrsmerde,and coma aulbFatib fadlltlpe that prooen wsd cul d also most thaw regWramente,enpinMrlrq <br /> arllnwtbne ottani InteprNy end nanclnl aaswanaee lorelaure an et:cldenld riiseesa.It to lawtul Io soot Uead ee to out-0fetete factldsa that amply <br /> ony was federN asst a mimpemant etendarde end nal t wee more etdnpent rbgi lremerlla By signing aha Invoice the penerelor osr86ea that DN <br /> penpratorhee eelablbhed s program loroduas the volumeaquentiy end taxMllyoflhe hezardoua waaW t0 the dpMe,as datormhrefr byperaemtor,to be <br /> ecorlamlce ty pMosashle.By both parties algMng We <br /> Invela t wlffl eerie ae an epreemem that Kam CNI will suhmk eonarmetone for(arlaln weetq , <br /> eUasme)Wt epensratorfhstthskwaatehas o benspa dtoellcenced treatmantor tramhrfaelllty. <br /> RlverbaNcoilTransrer 'RI NAME day; .L (Js,�y'YnnJ NAME <br /> ano Claus Rd,BMp 11 ADDRE88ADDRESe f <br /> Riverbank,CA 068af CRYL.r,�.r e:' :i e.1.J/ CITY <br /> Ph:20M63-0888 Fax:20M83-0887 <br /> P-PAk CALOOpirW616 STATE'ZJP STATE,ZIP <br /> PHONE 4r1 3� SL PHONE <br /> EPA ID <br />