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Send Payment TO <br /> 2355 Road 192, Delano CA 93215 <br /> IBMr r Ph : 209-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000367042 ID #46-0727047 <br /> Job Site LIC.AND IN SU RED TRANSPORTER#3468 MCP#CA 130615 <br /> GENERATOR /I <br /> Site EPA ID# Invoice No. M ; <br /> Contact Person <br /> Company Name 0 vt t��P�/ e �i-, ,Bill TO <br /> Address <br /> Name <br /> City, State,Zip Address <br /> Site Phone City, State, Zip <br /> Date Customer PO Interval Net 3 C.O.D./Cash/Check Drivers Truck/Name <br /> Waste CA Manifest# Quantity Units Price Amount <br /> PRODUCT Code <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) 221 0 Z 0002 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 <br /> Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated - Drum(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 6>{um(s) <br /> . Dlums(s) <br /> Drained Used Oil Filter Drum(s) <br /> Each <br /> Empty Drum(s) HR <br /> Transportation&Truck Time&Washout <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 Z <br /> co <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 rttixed this waste with any other waste that the total halides are less t�00 <br /> e t 0 PPM,and that the waste does not contain <br /> 'aJ'cept-the additional charges for legal disposal If this,waste is ov9"160 P ,total halides,or contains any PCB's <br /> any PCB's.I further agre <br /> GENERATOR or f DRIVER SIGNATURE// <br /> AUTHORIZED <br /> TERMS:INVOICES OVER 30 DAYS ARE SUBJECT TOA 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAY ALL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARY TO,COLLECT THIS INVOICE. with <br /> Kern orted to a facility that is ilhere by advises <br /> to managemenenerator t of usedoil. that isrnot required to comply wiof used oil th thebe morestringent requirrements applicable to huired to azardous waste) <br /> regulations <br /> es hhandle <br /> oil are <br /> etfacilities.Kern <br /> OtRqauthorized <br /> file <br /> tfor <br /> tiil ltiemesengBering <br /> requireddo meetthose mestngentreuiremensandsomeoufof-sate facile at process used o &also equr <br /> certifications of tank integrity,and financial assurances for closure an accidental releases.It is lawful to send used oil to out-of-state facilitiethe generator <br /> s that comply <br /> ements <br /> has witifedeedused <br /> a managemen <br /> educesthev oldume or quantity and toxicitys and notthose more nof therhazardous waste toethe degreinvoice e,asndetermcned by grtifies enerator,a actor, to be <br /> economically practicable.By both parties signing this invoice itwill serve as an agreement that Kern Oil will submit confirmations for(certain waste stPeams) <br /> to thegeneatorthattheirwastehasbeentransportedtoalicencedtreatmentortransferfacility. sr <br /> NAMF, <br /> NAME ADDRESS Riverbank Oil Transfer ADDRESS <br /> 5300 Claus Rd,Bldg 11 ADDRESS CITY <br /> Riverbank,CA 95387 CITY STATE,ZIP <br /> Ph:209-863-0888 Fax:209-863-0887 STATE,ZIP <br /> EPA#CAL000190816 PHONE PHONE <br /> EPA ID <br /> EPA ID <br />