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�V] J <br /> r r r <br /> Job Site : 2355 RD. 192 DELANO, CA 93215 <br /> GENERATOR Ph.: (209) 863-0888, FAX (661) 725-0654 <br /> Site EPA ID# i �� " ./ ] I D#46-07270471 CAL000367042 <br /> LIC,AND INSURED TRANSPORTER#3468 <br /> Contact Person - <br /> _ Invoice Na. M � � �: � <br /> Company Name `� 6 + " <br /> P Y C z_ h'-a a;. � Bill To <br /> Address �,= 1 �i Name <br /> City, State, Zip r , U r Address <br /> Site Phone _ •'�_; - ? City, State,Zip <br /> Date Customer PO Interval Net 301C.O.D.JCashlCheck Drivers Truck/Name <br /> ;!; <br /> PRODUCT Waste CA Manifest# Quantity Units Price Amount <br /> Code h' <br /> Non-RC RA Hazardous Waste Liquid(Used Oil) 221c_.> i_ - E f Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 ,ti r Gal <br /> Nan-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 L} y; _ -; �: '~ Gal 2) <br /> Non-RCRA Hazardous Waste Solids Contaminated pmm(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil <br /> Drained Used Oil Filter Drum(s) prurn�s <br /> Empty Drum(s) Each <br /> Transportation&Truak Time&Washout HR. <br /> Hazardous Testing <br /> We pay El 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 RATEOF 7B%. L l= <br /> I hereby certify that I have not rrWed 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 further agree to�.accept 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:INV tC OVER 3d DAYSARE SUBJECT TO A 1.51%SE=RVICE CHARGE CUSTOMER AGR1±E� -L-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 applicable to hazardous waste management facilities. <br /> Kam Oil Filter Recycling is.auttiorized to file a request for EPA#from DISC.Cafifomia 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 meet those 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 /> agreement that Kern Oil will submit confirmations for(certain waste streams}to the generator that theirwaste has been transported to a licenced treatment or transfer <br /> facility <br /> I California Oil Transfer El BTI ❑ NAME <br /> 5340 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:299-863-8171 PHONE <br /> EPA#CAL000190816 EPA ID <br />