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/11111 <br /> AE"*N 1Zl <br /> . <br /> f � <br /> Job Site : 2355 RD. 192 DELANO, CA 93215 <br /> GENERATOR Ph.: (209) 863-0888, FAX (661) 725-0654 <br /> Site EPA ID#` 1 I D# 46-0727047 / CAL000367042 <br /> LIC.AND INSURED TRANSPORTER#3488 <br /> Contact Person Invoice No. M <br /> ' Bill To : <br /> Company Name <br /> Address ' ' 4 Name <br /> City, State, Zip Address <br /> Site Phone City, State, Zip <br /> Dateustomer PO Interval Net 30/C.O.D./Cash/Check Drivers Truck/Name <br /> C <br /> PRODUCT waste Code nifes # Quantity Units Price Amount <br /> Non-RCRA Hazardous Waste Liquid(Used 011) 221 Gal <br /> Nan-RCRA Hazardous Waste Liquid(Oil&Water) 223 ' Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 1331 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated tNIs� <br /> Nom-RCRA Hazardous Waste Solids Contaminated with Used Oil !� Drum(s) <br /> Drained Used Oil Filter Drum(s) <br /> Empty Drum(s) Eadi <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 TOtair <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per mooti�i,which is the �Y <br /> ANNUAL PERCENTAGE RATE OF 18% - <br /> I hereby certify that I have not mixed this waste with any other waste that the total halides are less t an 1060 PPM,Jand that the waste does e0ntain <br /> any PCB's.I further agree to accept the additional charges for legal disposal If this,waste is over 1000PP ,total midis,or contains any PCB's <br /> GENERATOR or` i <br /> AUTHORIZED: f .`-4'--- 1(_`0': L``— DRIVER SIGNATURE <br /> TERMS: INVOICE OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREE O 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 regulations <br /> applicable to management of used oil.But that is not required to comply with the more stringent requirements appticable to hazardous waste management facilities. <br /> Kern Oil Filter Recycling is authorized to File a request for EPA#from DTSC.California facilities that handle or process used oil are required to meet those more <br /> stringent requirements,and some out-of-state facilities that process used oil&also meetthose requirements,engineering certifications of tank integrity,and financial <br /> assurances for closure an accidental releases.It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards and <br /> not those more stringent requirements By signing the invoice the generator certifies that the generator has established a program to reduce the volume or quantity <br /> and toxicity of the hazardous waste to the degree,as determined by generator,to be economically practicable.By both parties signing this invoice it will serve as an <br /> ag ree me nt th at Kern Oil wi11 submit Confirmations for(certain waste streams)to the generatorthatthe!rwaste has been transported to a licenced treatment ortransfer <br /> facility. <br /> ❑ California ail Transfer ❑ BT1 ❑ ❑ NAME 1 F a I 1 1 I f I <br /> 5300 Claus Rd,Bldg 11 1620 E Brundage Ln ADDRESS <br /> Modesto,CA 95357 Bakersfield,CA 93307 CITY <br /> Ph:209-863-8181 CAL000282598 STATE,ZIP <br /> Fax.209-863-8171 PHOT 't <br /> EPA#CAL000190816 EPA ID f t �� <br />