Laserfiche WebLink
i r <br /> 4 Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> 4 • • <br /> Ph:209-863-0888 - F2)(.:209 863-3887 <br /> MPA#CAM.aeo 042 ID#46-0727047 <br /> -Job Site : .MU 1111SURFMnAlISPORTER193469 MCP#CA 130615 <br /> GENERATOR <br /> nvoice <br /> Site EPA fr}# 72i",r <br /> ConW Person M <br /> company Name �gr Biu-1'0- <br /> Address �l 1 i 7.rte: f r,. Name <br /> City,State,Zp .. �. : <br /> Address : <br /> ! � <br /> Site Phonei i: yam'- "f7".' City,State,Zip <br /> Date/ v r Customer PO Interval N4t30/C.0.DJCasWCh6&1 Drivers TruddNarrre <br /> PRODUC WCode CA Manifest# Quantity Units: "Price . Amount <br /> {Ott-RCRA Haratdals Waste . IGO 5&r <br /> (A 2'11. <br /> Non-R4 illazardous 1lVa i�glad{ $Water) Gm <br /> Nan-RCRA Hazardmw.W:ade URM j*ftmoftA ) 133 Gai <br /> Non-RCRA HWv* sWadeS d <br /> `Non-RCRA,NimdotiiWastesows.!t!!!!wihUsedoI- } <br /> Dmi W Lised 09 l�D w(S). <br /> Empty Dwn(S) <br /> ESI <br /> TumptntalW&Truck Time&Washouti HR. <br /> hazardous Tesfing <br /> we pay El ( Pays[ <br /> Unless otherwise spaced ata mis t:onso MunWea Receipt c, t-rte:nocmwnue op the 10th or uw <br /> mowft ofprase.Past die accowts will chmaed a Rt�GE CHARGE at 1heP RA7E of 1.5%per <br /> whet,�s a� Total <br /> anu+tU11L PE YTfiGE.RATE OF 18%_ r <br /> a <br /> I hereby Cerrtiffy that I nave not mixed waste vAh arty atter waste that the tcdWHalides are less than 1000 PPM, ad ttmt thevaads dbas trot,wnwn <br /> any PCii s t tanner agree act ct-mec fdr logo dsposat If Uft,waste is over lana PPut.4aW trai[dks.cw'aa ns":any PCIrs <br /> AUiN DRtVC-R SICUJATURE <br /> TERMS:MNV ES AVER 30 DAYS SUBJECTTO A-1.5%SERVICE CHARGE CUSTOMER AGREED TO PAYALL LEGAL FEES OF COURT . <br /> ACTION I#ECOMutES}NECESSARY TO COLLECT THS t a"CE: <br /> Kem.ohlherebyadvisestheabove notGenemamsshsprrreritarusedorfmaybeiraspoitedtoafagTitytfratisrequiredtoc0mptywith%deral <br /> noble to: of used:o Sul#►atis not <br /> in wiEtt lFie mare stringertf app le fo tiazardotas <br /> '!�egulatiotis'appl' rrrnrr Y <br /> management t 3dwes.Item OR filter g is auuwrb ed io trio s requestfor EPA#frrrrrr DTSC-C.at+�arrua faaltties that har�e or.ptnGem t13ed b�are <br /> required to,meet those more strergent wW some a�t-of-fatetacames that process used oa 8 also meet mse"iequ¢>emerr5s,ertginee[in9" : <br /> certifi'Calions a tank integrity,;and assurancesirn closure an acikdentai releases.h iS iawfoi t4 sent!used oa to out of-state facliities fod c Wy <br /> orsywith fademlused oil mariagema3rat andnotamserrtorestrtngentrequisementsByagningtheiriv�r��egenerabor esthatthegetierator <br /> ties established a program to reduce the volume or qua nW arrd t D&Ay of the haa3t ldm waste to the degree,as.de by ger>erafo :ici be <br /> etwnomh�ilypiactimble_Byboth Ognbgthisurvaee1twil>setveasau nentthatKemOJIVA irit�for(certanivamostreams): <br /> tott 9mmatorthattheirwastehas tmnsportedioaiicencedtreaUnentortr %cmty <br /> MUtvetbarak Oa Transrer a NAME NAME <br /> ,5=,.lams Rd,Birtg.ll ADDRESS ADDI�SS <br /> R+vetnrc,wl 353e� cMY crrY <br /> Pfl' 1 $B$ Falc STATIf.ZiP STATE,ZtP <br /> EPA#CALtXl0191331& PHONE PHONE <br /> EPA ID t3rA ID ' <br />