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i <br /> Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> ERE <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000363253 ID# 77-0379490 <br /> Job Site : LIC.AND INSURED TRANSPORTER#3468 MCP# 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 /> PRODUCT waste Code CA Manifest# Quantity Units Price Amount <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Nan-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Drums) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil Drums) <br /> Drained Used Oil Filter Drum(s) Dru*s) <br /> Empty Drum(s) Each <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 <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 f d <br /> ANNUAL PERCENTAGE RATE OF 18%. <br /> 1 hereby certify that I have not mixed 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 or <br /> AUTHORIZED: DRIVER SIGNATURE: <br /> TERMS: INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREED TO 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 <br /> regulations applicable to management of used oil. But that is not required to comply with the more stringent requirements applicable to hazardous waste <br /> 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 <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 only <br /> with federal used oil management standards and not those more stringent requirements By signing the invoice the generator certifies that the generator has <br /> 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 <br /> practicable.By both parties signing this invoice it will serve as an agreement that Kern Oil will submit confirmations for(certain waste streams)to the generator <br /> that theirwaste has been transported to a licenced treatment or transfer facility. <br /> Riverbank Oil Transfer ❑ NAME 0 NAME <br /> 5300 Claus Rd,Bldg 11 ADDRESS ADDRESS <br /> Riverbank,CA 95387 CITY CITY <br /> Ph:209-863-0888 Fax:209-863-0887 STATE,ZIP STATE,ZIP <br /> EPA#CAL000190816 PHONE PHONE <br /> EPA ID EPA ID <br />