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Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> EPA$CAL000367042 ID #46-0727047 <br /> Job Site : LIC.AND INSURED TRANSPORTER#3468 MCP#CA 130615 <br /> GENERATOR <br /> Site EPA ID# <br /> Invoice No. M <br /> Contact Person <br /> Company Name ( `'` BIII To <br /> Address - J Name <br /> City, State,Zip ( {. Address <br /> Site Phoney City, State,Zip <br /> Date Customer PO Interval Net 30/C.O.D./Cash/Check Drivers Truck/Name <br /> Waste <br /> PRODUCT Code CA Manifest# Quantity Units Price Amount <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 ms) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil Dfum(s) <br /> Drained Used Oil Filter Drum(s) ` , i„ <..'. Druff►sis) <br /> Empty Drum(s) DO <br /> Transportation&Truck Time&Washout HR. <br /> Hazardous Testing <br /> We pay❑ Customer Pays❑ -- -- <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th 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 Total <br /> ANNUAL PERCENTAGE RATE OF 18%. <br /> it <br /> I hereby certify that I have not mixed this waste with any other waste that the total halides are less than 1000 PPM,and that thewaste does-not tain <br /> any PCB's.I further agree to accept the additional charges for legal disposal If this,waste is over 1000 PPM,totaIjiMides,or contains any PCB's <br /> GENERATOR or <br /> AUTHORIZED: DRIVER SIGNATURE <br /> TERMS:INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAY ALL 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 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 Oil Fitter Recycling 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-state 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 it will serve as an agreement that Kern Oil will submit confirmations for(certain waste streams) <br /> to the generator that their waste has been transported to a licenced treatment or transfer facility. <br /> Riverbank Oil Transfern NAME / �� �160r ' NAME <br /> 5300 Claus Rd,Bldg 11 , ADDRES t c ADDRESS <br /> Riverbank,CA 95387 CITY tA / -,,. CITY <br /> Ph:209-863-0888 Fax:209-863-0887 <br /> EPA#CAL000190816 STATE,ZIPL STATE,ZIP <br /> tf1�i r.(' <br /> PHONE - t S ' "L%> PHONE <br /> EPA ID �� ` ` r EPA ID <br />