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Send Payment TB <br /> 2355 Road 192, 3 1 <br /> �� <br /> Ph : 209-853-0888 - Fax : 9-863-08��r <br /> _ <br /> EPA#CALD00367042 ID#46-072704� G 0 6 2016r <br /> Job Site : LIC.AND INSURED TRANSPORTER43458 MCP# CA 13D6T3"VIf?0 <br /> jVMGENERATOR DEPgRT-rq 'y�CT <br /> Site EPA 1D# C ^y ,b(_ Invoice No. MQ <br /> Contact Person <br /> Company Name,,,, �: ;,°;� C..;;j\; ,: ==� Bill To : <br /> Address ' - °.L'.' L , ` . ` / 1' ti$ Name <br /> City,State,Zipk Address <br /> Site Phone i :. `'. .t '- ; '.a`. a,7 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 /> NDn-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Cntlm(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil <br /> Drained Used Oil Filter Drum(s) Drxs(s) <br /> Empty Drum(s) ,`7G' <br /> Transportation&Thick Time&Washout HE <br /> Hazardous Testing <br /> We pay ❑ Customer Pays *, <br /> Unless otherwise speorM on this Consolidated Manifest Receipt(invoice)Terms:Accounts Cue on the 10th of the month todaMrig <br /> month of purchase.Past due accounts will be charged a FINANCE CHARCIE at the PLJ2i0DIC RAfF-of 1.5%per month,which is tT4311 <br /> he r z i{ <br /> ANNUAL PERCENTAGE RATE of 18%. rte. <br /> 3 <br /> I hereby certify that I have not mixed ttifs waste with any other waste that the total halides are less than 10QD PPM,and that the waste does not contain <br /> any PCB's,l furher agree to acce�tithe additional charges for legal disposal if this,waste is over 1 ,tela i>�alfdes,or contains any PCB's <br /> GENERATOR or\ ,'/f ,` <br /> AUTHORIZED: N; / ` '� I DRIVER SIGNATURE <br /> TERMS:INVOICES 6YE[K 4 DAYS-AR; s JECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAYALL 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 wMh federal <br /> regulations applicable to management of used oil.But that is not roquirod to comply with Lhe more stringent requirements applicable to hazardous waste <br /> management facilities.Kern Oil Filter Recycling is authorized to file a request for EPAft from DTSC.California facilities that handle or process used oil are <br /> required to meet those more stringent requirements,and some out-ot-state faculties that process used oil&also meet VwSe 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 tho degree, as determined by generator, to be <br /> economically practicable.By both parties signing this invoice itwV 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 iiconced treatment ortransfarfacility. fI <br /> Riverbank Oil Transfer NAME E NAME' Ir ^i rl <br /> 5300 Claus Rd,Bldg 11 ADDRESS ADDRESS <br /> Riverbank,CA 95387 CITY CITYt r <br /> Ph:209-863-0888 Fax:209-863-0887 STATE,ZIP STATE,ZIP <br /> EPA#CAL000190816 PHONE PHONE 4r 7 ,t <br /> EPA ID EPA 1D <br />