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M r r r Job Site : 2355 RD. 192 DELANO, CA 93215 GENERATOR Ph.: (209) 863-0888, FAX (661) 725-0654 Site EPA ID#: .`:,o` f' ', fr-`, ;: ID# 46-07270471 CAL000367042 3 r LIC.AND INSURED TRANSPORTER#3468 Contact Person f Invoice No. Company Name ' , Bill To : Address " " Name City, State, Zip �`L , v Address Site Phone City, State, Zip Date r Customer PO interval Net 30/C.O.D./Cash/Check Drivers Truck/Name PRODUCT Waste CA Manifest# Quantity Units Price Amount Code Non-RCRA Hazardous Waste Liquid(Used Oil) 221 ,„” E Gal '' ti Non-RCRA Hazardous Waste Liquid(Oil&Wafer) 223 Gal Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal Non-RCRA Hazardous Waste Solids Contaminated Drum(s) Non-RCRA Hazardous Waste Solids Contaminated with Used Oil Drum(s) Drained Used Oil Filter Drum(s) Drams(s) Empty Drum(s) Eads Transportation&Truck Time&Washout HR. Hazardous Testing We pay ❑ Customer Pays,,... Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the,month following TotI month of purchase.Past due accounts will be charged a FINANCE CHARGE of the PERIODIC RATE of 1.5%per-nonth,which is the ANNUAL PERCENTAGE RATE OF 18%. ' "' } I hereby certify that I have not mixed this waste with any other waste that the total halides are less than 1000 PPS;and that the waste does not contain any PCB's. I further agree to accept the additional charges for legal disposal If this,waste is over 1001 PPM,t9#,1a1,hall es,or contains any PCB's GENERATOR or AUTHORIZED: DRIVER SIGNATURE: F TERMS: INVOICE OVER 30 DAYS ARE SUBJECTTO A 1.5%SERVICE CHARGE CUSTOMERAGD TO PAY ALL LEGAL FEES OF COURT ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. i` 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 applicable to management of used oil.But that is not required to comply with the more stringent requirements applicable to hazardous waste management facilities. 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 stringent requirements,and some out-of-state facilities that process used oil&also meet those requirements,engineering 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 only with federal used oil management standards and 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 and toxicity of the hazardous waste to the degree,as determined by generator,to be economically practicable.By bath parties signing this invoice it will serve as an agreement that Kern Oil will submit confirmations for(certain waste streams)to the generator that theirwaste has been transported to a licenced treatment ortransfer facility. NAME `RdaaraJrOil Transfer ❑ Yuma Environmental Services ❑ Global Material Management ❑ 5300 Claus Rd,Bldg 11 2730 E. 13th Street, ADDRESS Riverbank,CA 95387 Yuma,AZ 85365 CITY Ph:209-863-0888 Ph.:928-642-8938 STATE,ZIP Fax:209-863-0887 Fax:928-344-9828 PHONE EPA#CAL000190816 EPA ID:AZR000515924 EPAID