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Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> fin r 1 <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> I1� 111I EPA#CAL000367042 I D#46-0727047 <br /> Job Site : LIC.AND INSURED TRANSPORTER#3468 MCP#CA 130615 <br /> GENERATOR <br /> Site EPA ID# C A� Uva�� ,ij 72 <br /> Invoice No.Mo t; <br /> Contact Person <br /> Company Name ,fr,-2r1 L AIll- I 1—aAc(fr2 f�IF7[�o <br /> Address -?fl S c(s l✓,1 Name <br /> CityState,Z!p Address <br /> Site Phone 2,o Ci State,Zip <br /> Date Customer PO Interval Net 30/ .O.D./Cash/Check Drivers Truck/Name <br /> IJ j Ir <br /> PRODUCT waste CA Manifest# Quanti Units Price Amount <br /> Code lY <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) 221 Gal <br /> Non•RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Drum(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil X31 <br /> Drained Used Oil Filter Drum(s) <br /> Empty Drum(s) Eads <br /> Transportation&Truck Time&Washout Iql <br /> Hazardous Testing <br /> We pay❑ Customer Pays' ? <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Involce)Terms:Accounts due on the 1001 of the month following , <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which is the T#1 <br /> ANNUAL PERCENTAGE RATE OF 18%. <br /> 1 hereby certify that I have not mixed this waste with any other waste that the total halides are less than 1000 PPM,and that the waste o@s not cont n <br /> any PCB's.I further agree to accept the additional charges for legal disposal If this,waste Is over 1000 PP ,tole halitfes,or contains any PCB's <br /> GENERATORor r f\ <br /> AUTHORIZED: I DRIVER SIGNATURE: <br /> TERMS:INVOICES OVER 30 DAYSIARE SUBJECT TOA 1.5%SERVICE CHARGE CUSTOMER REED TO AYALL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARY Td C&LECT THIS INVOICE. <br /> Kern Oil hereby advises the above Gelipprator that Generators shipment of used oil maybe 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 <br /> management facilities.Kern OII Filter kecycling is authorized to file a request for EPA#from DTSC.California facilities that handle or process used oil are <br /> required to meet those more stringent requirements,and some out-of-slate facilities that process used oil&also meet those requirements,engineering <br /> certifications of tank Integrity,and financial assurances for closure an accidental releases.It Is lawful to send used oil to out-of-state facilities that comply <br /> only with federal used oil management standards and not those more stringent requirements By signing the invoice the generator certifies that the generator <br /> has established a program to reduce the volume or quantity and toxicity of the hazardous waste to the degree, as determined by generator, to be <br /> economically practicable.By both parties signing this Invoice Awill serve as art agreement at Kern oil will submit confirmations for(certaln waste streams) <br /> to the generator that thelrwaste has been transported to a llyepc#dleatme tortransfe facility. <br /> (( /l l/ <br /> F] Riverbank Oil Transfer YY NAME r 'd v I ❑ NAME <br /> 5300 Claus Rd,Bldg 11 ADDRADDRESS <br /> Riverbank,CA 95387 CITY r CITY <br /> Ph:209-883.0888 Fax:209-883-13887 ti.r,� <br /> EPA#CAL000190816 STATE,ZIP STATE,ZIP <br /> PHONE � 4• UI� PHONE <br /> EPA ID 7 r . .f t EPAID <br />