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2900 - Site Mitigation Program
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PR0542676
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COMPLIANCE INFO
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Entry Properties
Last modified
12/2/2020 11:18:44 AM
Creation date
7/27/2020 9:04:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0542676
PE
2953
FACILITY_ID
FA0024554
FACILITY_NAME
JOHNS, WILLIAM D
STREET_NUMBER
1640
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
1640 N BROADWAY AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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' t <br /> i <br /> 4 Send Payment To: <br /> �`�► 2355 Road 192, Delano CA 93215 <br /> Ph : 20M63-0888 - Fax : 209-863-0887 <br /> EPA 9 CALOOD367042 I D#46-0727047 <br /> Job Site : LIC.AN9 INSURED TRANSPORTER#3468 MCP#CA 130615 <br /> GENERATOR <br /> Site EPA ID# L a <br /> Invoice No i ° '� ; ` <br /> Contact Person <br /> Company NameQ10j Bill To : <br /> Address AAI e , Name <br /> City, State, Zip Address <br /> Site Phone City, State,Zip <br /> Date CusttT <br /> nterval Net 30/C.O.D./Cash/Check Drivers Truck/Name <br /> Ca I �' o✓t <br /> PRODUCT 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 Aullilmotive Anlikeeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contam ted DIA5) <br /> Non_RCRA Hazardous Waste Solids Contam' ed with Used Oil M5) <br /> Drained Used Oil Filter Drum(s) _ !SI <br /> Empty Drum(s) <br /> Transportation&Truck Time&Washout <br /> Hazardous Testing <br /> We pay❑ Customer Pays <br /> Unless otherwise specified on this Consolidatedrfest Receipt(Invoice)Terns-Accounts due on the 10th of the month following Tota) <br /> month of purchase.Past due accounts will be chard a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which is the <br /> ANNUAL PERCENTAGE RATE OF 18%. TTT <br /> I hereby certify that I have not mixed this wast with any other waste that the total halides are e s th 1000 PP d that the waste does not contain <br /> any PCB's.I further agree to accep tpe additional charges for legal disposal If this,waste is 1 �PM'tnt l es,or contains any PCB's <br /> GENERATOR or I i <br /> AUl HORIZED: L" DRIVER SIGNATURE: <br /> TERMS:INVOICES OVER 30 DAYS ARE S ECT TO A 1.5%SERVICE CHARGE CUS _R O PAY A AL FEES OF COURT <br /> ACTION BECOMES NECESSARY TO COLL TTHIS INVOICE. <br /> Kem Oil here by advises the above Generato�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 mej oil.But that is not required to comply with the more stringent requirements applicable to hazardous waste <br /> management facilities.Kern Gil Filter RecyclirlIg is authorized to file a request for EPA#from DISC-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 as$urances for closure an accidental releases.It is lawful to send used oil to out-of-state facilities that comply <br /> oniywith federal used oil management standards and not those more stringent requirements By signing the invoice the generator certifies that the generator <br /> 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 <br /> economically practicable.By both parties signithg this invoice it will serve as an agreement that Kem Oil will submit confirmations for(certain waste streams) <br /> to the generator that their waste has been transported to a licenced treatment or transfer facility. <br /> 6RKC'bank Oil Transfer L j NAME NAME <br /> 5300 Claus Rd.Bldg 11 ADDRESS ADDRESS <br /> Riverbank,CA 95387 CITY CITY <br /> Ph:209-883-0888 Fax:209-863-0887 STATE,ZIP — _____ STATE,ZIP— <br /> EPA#GALvoo190a16 PtIONE _—_ PHONE <br /> EPA ID EPA IC <br />
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