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05-03-'12 10:25 FROM- T-363 P004/007 F-839 <br /> Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> Ph :209-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000363253 ID#77-0379490 <br /> Job Site . LIC.AND INSURED TRANSPORTER#3468 MCP#CA130615 <br /> GENERATOR{'(;: , (-% , <br /> Invoice No. <br /> Contact Person <br /> Company Name 1 til; r't . ! i.t 1 Bill TO : <br /> Address �1 `,,, Name <br /> City, State, Zip c •(' '' Address <br /> Site Phone L L City, State,Zip <br /> Date + Customer PO InteryyI Nst 30/C.O.D.ICash/Check Drivers Truck/Name <br /> PRODUCT fade CA Manifest# Quantity Units Price Amount <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) 221 4; i 1.1•} �, ' t !(°` �G ( 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 OROS) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil Dms(s) <br /> Drained Used Oil Filter Drum(s) Dr.0s) <br /> Empty Drum(s) <br /> EA <br /> Transportation&Truck Time&Washout W' <br /> Hazardous Testing <br /> We pay Customer Pays[� <br /> Unless otherwise spedried an this Consolidated Manifest Receipt(Invdcej Terms:Accounts due on the loth of the month fallowing TDial f• <br /> month of purchase.Past duo accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1,15%par month,which is the <br /> ANNUAL PERCENTAGE RATE OF 16%. <br /> I hereby certify that I have not mixed thi9 waste With any other waste that the total halides are less than 1000 PPM,and that the <br /> maf S a�PCB as not contain <br /> any PCB's. I furth„fir ag7res to accept thea itionaf C "es for legal disposal If this,waste is Over 7000 RPM,total halm ts,pr Y <br /> GENERATOR or'V ~,w�4• b \1`�1.� t,tr,�'�. <br /> AUTHORIZED: R DRIVER SIGNATURE : <br /> TERMS: INVOICES OVER 30 DAYS ARE SU TOA 1.5%SERVICE CHARGE CUSTOM R AGREED TO PAYALL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br /> Kern Oil here by advises the above Generator that Generators shipment of used Oil may be transported to a facility that is required t,comply douwith federal <br /> regulations at to management of used oil, out that Is not required to comply with the more stringent requirements applireblm to hazardous waate <br /> ste <br /> management facilities.Kam Oil Filter Recycling is authorized to file a mqueot for EPA#from OTSC.Cali mia fadltleS III handle or process used Oil <br /> required to most those more stringent requirements,and some out-offfecifities that process used oil&also meet those requirements,engineering <br /> certifications of tank integrity,and financial assurances for closure an accidental releases.If is lawful to send used oil to out-of-stats facilities that comply only <br /> With federal used oil management standards and not those more Stringent requirements By signing the Invoice the rm ined b certifies or,to bee9�om��gy <br /> established a program to reduce the volume or quantity and toxicity of the hazardous waste to the degree,as determined by generator, <br /> practicable.ply both parties signing this invoice Awill serve as an agreement that Kern Oil will submit confirmations for(certain Waste streams)to the generator <br /> thattheirwasts has been transported to a licenced treatment orlransf r//facility. <br /> — ''” l"' - NAME <br /> Riverbank Oil Transfer I , ADDRESS <br /> 5300 Claus Rd,Bldg 11 '--v' pppRE99 CITY <br /> Riverbank,CA 95387 CITY' <br /> Ph:209.863-0888 Fax:208-063-0897 STATE,ZIP STATE.ZIP <br /> EPA#CAL000190e16 PHONE PHONE <br /> EPAID EPAID <br />