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t•�-_•w�eu. Mr r_-- <br /> AUG 1 5 2016 <br /> Send Payment To: w <br /> 2355 Road 192, Delano CA 93215 11 /'" <br /> ® r <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> 1L!ld1�J11�L,`UI EPA#CAL000367042 ID#46-0727047 <br /> Job Site . LIC.AND INSURED TRANSPORTER#3466 MCP#CA 130615 <br /> GENERATOR j <br /> Site EPA ID# CA e,&0 X11 w rl � Invoice No. M d 6 L � u <br /> Contact Person <br /> Company Name, ;r , itif ! ar;5 Bill To : <br /> Address 1�f "L s- <br /> �c- - 'V/. Name <br /> City,State,Zip f ;l , 1 Address <br /> Site Phone I, c `?' 'r �% ' `I,j 1 City,State,Zip <br /> VNor-RCRA"Hazardous <br /> Customer PO Interval Net 30/C.O-D./Cash/Check DrNers Truck/Name <br /> ( �l icPRODUCT Codte CA Manifest# Quantity Units Price Amount <br /> Waste L'Iquid(Used Oil) 721 Gal <br /> rdous Warta Llouid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waslte Liquid(Used Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Dur(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil s <br /> Drained Used Oil Filter Dmilri(s) SI G pur6(s1 ' S <br /> Z 5 <br /> Empty � iSo Drum(s) _ _ <br /> Transportation&Truct Time&Wastart tR <br /> Hazardous Testing <br /> We pay❑ Customer Pays ?r l <br /> Unless otherwise specified on this Corwlldetetl Manifeet Recdpt(Invoice)Terms:Axo dueonthe lothofthernIthfollowing TOt4I <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of i.a%per month,whiUr 3 the <br /> ANNUAL PERCENTAGE RATE OF l it . <br /> I hereby certify that I have not mixed this waste with any other waste that the total halides are than 1 WOD PPM,and that the waste does not contain <br /> arty PCB's.1 further ogre•to accerYfFe�tlditional charges for legal disposal If this,waste is ever 000 ppltil.tothl yaI as,or contains any PCB's <br /> GENERATOR or �/'' ,YY� n / <br /> AUTHORIZED:,^ '^ DRIVER SIGNATURE:;' �lirc` !i <br /> TERMS:INVOIOES OVER 30 DAYS ARE SUBJECTTO A 1.5%SERVICE CHARGE CUO-POMERA15RIE&TOtPAY AL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. '• <br /> Kem 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.Kenn 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-stats facilities that comply <br /> onlywith federal used oil management standards and not those more stringent requirements By signing the invoice the generatorcertifies thatthe generator <br /> has established a program to reduce the volume or quantity and toxicity of tho hazardous waste to the degree, as determined by generator,to he <br /> economically practicable!By both parties signing this invoice @will serve as an agreement that Kern Oil will submit confirmations for(certain waste streams) <br /> to the generatorthattheir�ante has been transported to a licenced trea{trrntortransfer ility. 1 <br /> Riverbank Oil Trafar rfr FlJAMr�—r tL'i't !v NI( r.al .ttl''4n f'R{L$Itflll NAME <br /> rss <br /> �•'.rr rrl„iJr.;.� S?f7 ADDRESS <br /> 5300 Claus Rd,Bldg 11 ADDRESS�-, <br /> Riverbank,CA 9538711 CIN \^a C rC CITY <br /> Ph:209-863-0888 Fax:209-863-0987 STATE ZIP C51'51203 STATE,ZIP <br /> EPA#CAL000190816 PHONE -, -'Cl "rfr> PHONE <br /> EPAID r'r�r , C Cf S,L)it EPA ID <br /> C <br />