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TZ CEIVED <br /> SEP 222016 <br /> Send Payment To: ��� ENTAL HEALTH <br /> 2355 Road 192, Dela gFiTMENT <br /> r Ph : 209-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000367042 ID #46-0727047 <br /> Job Site : IC.AND IN SU RED TRANSPORTER#3468 MCP# CA 130615 <br /> GENERATOR <br /> Site EPA ID# l ,^ I Invoice No. Mj j; a <br /> Contact Person - .x <br /> Company Name 4;'r l� �)-r ' %'' 111 TO <br /> Address Name <br /> City, State,Zip l ; Address <br /> Site Phone ./- City, State, Zip <br /> Date, Customer PO Interval Net 30/C.0.D./Cash/Check Drivers Truck/Name <br /> PRODUCT waste Code CA Manifest# Quantity Units Price Amount <br /> Non-RCRA Hazardous Waste Liquid(U ed Oil) 221 - Gal <br /> Non•RCRA Hazardous Waste Liquid(0(I&Water) 223 -4 y, , - Gal <br /> Non-RCRA Hazardous Waste Liquid(U ed Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Colptaminated Drum(s) <br /> Non-RCRA Hazardous Waste Solids Co 6minated with Used Oil Drums) <br /> Drained Used Oil Filter Drum(s) Duos) <br /> Empty Drum(s) Eads <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 t1e charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which is the Total ) <br /> ANNUAL PERCENTAGE RATE OF 19%. <br /> I hereby certify that I have not mixed thi 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,car containgrAny 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 O PAY ALL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br /> Kern Oil here by advises the above Ge erator 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 same 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 <br /> only with 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 partie signing this invoice it will serve as an agreement that KennOil will submit confirmations for(certain waste streams) <br /> to the generator that their waste has bee transported to a I cenced treatment or transfer facility. <br /> a Riverbank Oil Transfer F1 NAME NAME <br /> 5300 Claus Rd,Bldg 11 ADDRESS ADDRESS <br /> Riverbank,CA 95387 CITY CITY <br /> Ph:209-863-0888 Fax:209-863-08817 <br /> EPA#CAL000190816 STATE,ZIP STATE,ZIP <br /> PHONE PHONE <br /> EPA ID EPA ID <br />