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Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> r r n <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> Job Site ; �LLLI �EPAA#1CAL000�3632533 ID #77-0379490 <br /> LIC.AND INSURED TRANSPORTER#3460 MCP#CA 130615 <br /> GENERATOR <br /> Site EPA I D# <br /> Contact:Person Invoice No. <br /> Company Name Bill To : <br /> Address Name <br /> City, State, Zip 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 /> Nan-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 Mot) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil <br /> Drained Used Oil Filter Drum(s) D mp) <br /> Empty Drum(s) Each <br /> Transportation&Truck Time&Washout NR. <br /> Hazardous Testing <br /> We pay Customer Pays <br /> Llnless otherwise specified on this Consolidated Manifest Receipt.Invoice)TermsAccounts due on the 10th of the month following is the <br /> Total <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month, <br /> ANNUAL PERCENTAGE RATE OF 1a%. ,t <br /> tal halides are less than 1000 PPM,and that the waste does not contain <br /> I hereby certify that I have not mixed this waste with any other waste that the to <br /> additional charges for legal disposal If this,waste is over 1000 PPM,total halides,or contains any PCB's <br /> any PCB's. I further agree to accept the <br /> 'GENERATOR or DRIVER SIGNATURE: <br /> AUTHORIZED <br /> S ARE SUBJECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAY ALL LEGAL FEES OF COURT <br /> TERMS: INVOICES OVER 30 DAY <br /> ACTION BECOMES NECESSARY TG COLLECT THIS INVOICE. with <br /> Kern Oil here b'cable advises <br /> management of used that <br /> tBut chart is nohrequired ment of <br /> comply witused oil hbhermoreostriringent requirto a ements appllicable to hazardousiwaste <br /> regulations apg tittles.Kern Oil Filter Recycling is authorized to file a request for EPA#from DTSC.California facilities that handle or process used oil are <br /> management i9C <br /> required ti meet those more sMngent Recycling <br /> is au, and some out-of-state facilities that process used oil &also meet those requirements, engineering <br /> certifications of tank integrity,and financial assurances forclosurean ad d not those more gccidental releases.It is lawful to send used oil to out-of-state facilities that comply only <br /> with <br /> federal <br /> a program todu management the volume or quantity and toxicity of the ent rhazardous wasuirements te tothedegree,the las detce theermined by genenerator erator, <br /> thatthe <br /> a econom economically <br /> practicable.By both parties signing this invoice it will serve as an agreement that Kern Oil will submit confirmations for(certain waste streams)to the generator <br /> thattheirwaste hasbeen transported toalicenc❑ ADDRESS <br /> ed tNAatmEent or lransferfacility. ❑ NAME <br /> ADDRESS <br /> ,. Riverbank Oil Transfer CITY <br /> Rive 209-863-0887 Claus Rd,Bldg 11 CITY STATE,ZIP <br /> Riverbank,CA 95387 STATE,ZIP <br /> Ph:209-863-0888 Fax: PHONE PHONE <br /> EPA#CAL000190816 EPA ID <br /> ' EPA ID <br />