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Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> r <br /> Ph :209-863-0888 - Fax:209-863-0887 <br /> ERE <br /> EPA 0 CALOOD363253 ID#77-0379490 <br /> Job Site LIC.AND INSURED TRANSPORTER 0 3468 CA 130615 <br /> GENERATOR <br /> Site EPA ID# Invoice No. <br /> Contact Person <br /> Company Name Bill To : <br /> Address Name <br /> City,State,Zip Address <br /> Site Phone City,State,Zip <br /> Date ; ,. Customer PO Interval Net 30/C.O.D./Cash/Check Drivers Truck/Name <br /> i <br /> PRODUCT ante CA Manifest# Quantity Units Price Amount <br /> Code <br /> Non-RCRA Hazardous Waste Liq id(Used Oil) 221 ; Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liq id(Used Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Dlullt(s) <br /> Non-RCRA Hazardous Waste So ds Contaminated with Used Oil Drum s) <br /> I <br /> " I <br /> Drained Used Oil Filter Drum(s) Drums(s) j <br /> Empty Drum(s) Each I <br /> Transportation&Truck Time&W hoot HR. i <br /> Hazardous Testing i <br /> We pay❑ Customer Pays <br /> Unless otherwise specified on this�nsolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the month following Total <br /> month of purchase.Past dueaccos will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which is theANNUAL PERCENTAGE RATE OF8%. - <br /> I hereby certify t=NECESSA <br /> d this waste with any other waste that the total halides are less than 1000 PPM,and that the waste does not contain <br /> any PCB's.I furtt the additional charges for legal disposal If this,waste is over 1000 PPM,total halides,or contains any PCB's <br /> GENERATOR o <br /> AUTHORIZED: DRIVER SIGNATURE: <br /> TERMS:INVOIS ARE SUBJECT TOA 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAYALL LEGAL FEES OF COURT <br /> ACTION BECOTO COLLECT THIS INVOICE. <br /> Kern Oil here by advises the ab Ive Generator that Generators shipment of used oil may be transported to a facility that is required to comply with federal <br /> regulations applicable to mane g ment of used oil.But that is not required to comply with the more stringent requirements applicable to hazardous waste <br /> management facilities.Kern Oil ifter 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 <br /> generator has established a program to reduce the volume or quantity and toxicity of the hazardouswaste 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 KernOil will submit confirmations for(certain waste <br /> streams)to the generator that th6ir waste has been transported to a licenced treatment or transfer facility. <br /> ❑Riverbank Oil Transfer ❑ NAME ❑ NAME <br /> 5300 Claus Rd,Bldg 11 ADDRESS ADDRESS <br /> Riverbank,CA 95387 CITY CITY <br /> Ph:209-863-0888 Fax:209- 63-0887 STATE,ZIP STATE,ZIP <br /> EPA#CAL000190816 PHONE PHONE <br /> EPA ID EPA ID <br />