Laserfiche WebLink
Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000367042 I D # 46-0727047 <br /> Job Site : LIC.AND INSURED TRANSPORTER#3468 MCP# CA 130615 <br /> GENERATOR <br /> Site EPA ID# _ Invoice No. Ivy <br /> Contact Person <br /> Company Name ' ;'` ,' . f BIII To <br /> Address f Name <br /> City, State, Zip �_T 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) Drums{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 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 : INVOICES OVER 30 DAYS ARE SUBJECT TOA 1.5% SERVICE CHARGE CUSTOMER AGREED TO PAYALL 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 <br /> onlywith federal used oil management standards and not those more stringent requirements By signing the invoice the generator certifies thatthe 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 signing this invoice it will serve as an agreement that Kern 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 /> Riverbank Oil Transfer ❑ NAME ❑ 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 />