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RECE � ; ��✓ � � <br /> pig c vc 'F+sa 9 <br /> � a i <br /> Job Site : 2355 RD. 192 DELANO, CA 93215 <br /> GENERATOR Ph.: (209) 863-0888, FAX (661) 725-0654 <br /> ID#46-0727047 / CAL000367042 <br /> Site EPA ID# ( _ -- _ - " .l LIC.AND INSURED TRANSPORTER#3468 <br /> Contact Person Invoice No. M <br /> Company Name!p - 41t•4t, Bill To : <br /> Address (j ,i 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 CA Manifest# Quantity Units Price Amount <br /> Code <br /> Non•RCRA Hazardous Waste Liquid(Used Oil) 221 - Gal - <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Drum(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil Drum(s) <br /> Drained Used Oil Filter Drum(s) Dmms(s) <br /> Empty Drum(s) Each <br /> Transportation&Truck Time&Washout HR. <br /> Hazardous Testing <br /> We pay ❑ Customer Pays❑ <br /> Unless otherwise specified onlbiSConsolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the month following Total ' ' <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 <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 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: INVOICE 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 /> Kem Oil here by advises the above Generatorthat Generators shipment of used oil may be transported to a facility that is required to complywith 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 /> 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 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 Kem Oil will submit confirmations for(certain waste streams)to the generator that their waste has been transported to a licenced treatment or transfer <br /> facility. <br /> ❑ California Oil Transfer ❑ BTI ❑ ❑ NAME <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 PHONE <br /> EPA#CAL000190816 EPAID <br />