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~"> co O � f e- N) � Z G1 ' w CD . D X � m s z 2355 RD. 192 DELANO, CA 93215Cn M Job Site : Ph.: (209)863-0888, FAX (661)725-0654 D = GENERATOR LIC, 46-0727047 1 CAL000367042 ro LIC.AND INSURED TRANSPORTER#3469 r Site EPA ID# _ A p a. Invoice No. � Contact Person Bill To : f o Company Name Address Name Ln (1 Address City,State,Zip _ m Cit State,Zip 0- Site Phone Y, 3 Date Customer POInterval Net 3D1G.O.D.1CashlCheck Drivers TruckiName (D ar+i waste PRODUCT code CA Manifest# Quantity Units Price Amount O Non-RCRA Hazardous Waste Liquid(Used Oi!} 221 Ga! o Nan-RCRA Hazardous Waste Liquid{Oil&Water) 223 Gal N Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal Q- v r+ Non-RCRA Hazardous Waste Solids Contaminated ]n m{sl m Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 17um4s} N V Drained Used Oil Filter Drum(s) 6nims{s} o Empty Drum(s) Eaci Transportation&Truck Time&Washout Hazardous Testing We pay❑ Customer Pays[ ' unless othefwise specified on this Consolidated Manifest Receipt(Invoice)Terms-Accounts due on the f Dth of the month foliowing Total month of purchase_Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per mouth,which is the ANNUAL PERCENTAGE RATE O3=18% ; I hereby certify that I have not mixed this waste with any other waste that the total halides are less than 1000 PPM, d that the waste does not contain any PCB's. I further agrge to accept the additional charges for legal disposal If this,waste is over 1000 PPM,total i tides,or contains any PCB's GENERATOR or '--/�_ L` f_ DRIVER SIGNATURE AUTHORIZED RT TERMS:INVOICE OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAY ALL LEGAL FEES OF COU ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. with the more stringent requirements applicable to hazardous waste management facillf" Kem 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 regutatfo applicabfe to management of used oil.But that is not required to comply r'Iand finer Kem Oif Filter Recycling is authorized to file a request for EPA#!from DTSC.California facilities that handle os process used oil are sequined to meet those m only with federal used oil management standards stringent requirements,and some out-of-state facilities that process used oil&also meet those requirements,engineering cediffcattons of tankmteg assurances for closure an accidental releases.It is lawful to send used oil to out-of-slate facilities that comply y ua racticable.By both parties signing this invoice it Will serve s not titvse more stringent requirements By signing the invoice the generator certifies that the generator has established a program to seduce the volume of q and toxicity of the hazardous waste to the degree,as determined by generator,to be economically thatly p agreement that Kem Oil will submit confirmations for(certain waste streams)to the generator that their waste has been transported to a licenced treatment or ra facility, ' ❑ ity, bank Oil Transfer El Yuma NAME Yuma Environmental Services ❑ Global Material Management ADDRESS �] 5300 Claus Rd,Bldg 11 2730 E. 13th Street, CITY o Riverbank,CA 95387 Yuma,AZ 85365 STATE,ZIP a Ph:209-863.0888 Ph,:928-642-8938 PHONE Fax:209 863-0887 Fax:928-344-9828 EPA 4D _ EPA#CAL000190816 EPA ID:AZR000515924 Cn QQ tit Y ��✓ +,. ' ) _ J.