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Job Site : LIC. <br />GENERATOR <br />Site EPA lD# <br />Contact Person <br />Company Name, <br />EPA CALOMS7862 <br />INSURED TRANSPORTER#3468 <br />fy <br />t: <br />` J r <br />Send Payment To. <br />2355 Road 192, Delano CA 93215 <br />Ph: 209-8634)) - Fax: 209-863-0887 <br />1D # 46-0727047 <br />MCP# CA, 130615 <br />' .% Invoice No, 4 . <br />Address "wv:.;�. <br />Name <br />City, State, -Zip <br />Address <br />Site Phone'=- - ; • - f , ` <br />City, Stale; Zip <br />Date- . <br />G tome PO <br />interval <br />Net 30TC.O.D./Cash/Gheck <br />Dfiyers Tnx*]Name <br />PRODUCT <br />WasteCodeCA <br />Manifest # <br />Qetarttity <br />units <br />Price <br />Amount <br />NOR -RCM Hazardous Waste Liquid {used <br />V <br />Non-RCRA Hazardous Waste Liquid(00 & ) . <br />223 <br />Gal <br />Non-RCRA HazardousWaste Liquid (Used motive Afr9mm) <br />133 <br />Gal <br />Non-RCRA Hazardous Waste Sob Co <br />Nan-RCRA Hazardous Waste Solids with Used 00 <br />) <br />DmW Used 00 Final Drum (S) <br />{s) <br />Empty Drum (s) <br />Ft�t <br />TramWWw&TRdTme.&VMW <br />NL I <br />HazardousTestnlg <br />We pay [] Cusbmer Pays <br />Unkw mise spedied ort UBS Mtartirest Recoo (invoice) Terms : Ancmmfs dm,m the f 0th of the rna�lh tUowmg <br />month of purchase_ Past dua accounts — be a FWAWCE CHARGE at the PMIOrXC RATE of 15% per month. which is the <br />ANNUAL PMCeaAGE RATE OF 18%. <br />Total <br />s <br />_1 I <br />;r J t <br />, Cr <br />I hareby codify that t have not mixed th)s v <br />any PCB's. I further agnea to accept thg,a( <br />GENERATOR * <br />AUTNORrlEDf` '- <br />TERMS.: INVOICES OVER 30 DAYS ARE <br />ACTION BECOMES NECESSARY TO CL <br />Kem Oil here by advises the abova Gene <br />regulations appl"tcable to management of <br />management facilities. Kern Oil Filter Rec <br />required to meet those more stringent to <br />cerlincations of tank integrity and feranc k <br />onfywah federal used oil managementsta <br />has established a program Uri reduce'th <br />economically practicable. By both parties, <br />tothe gener tm 0 tattheirwaste has been' <br />Riverbank Od Transfer <br />f f 53W Claus Rd, Bldg X11 <br />Riverbank, CA 95387 <br />F'h:209�8ti3-01i88 W.20W3-wi <br />EPAI CAIAl10MOM <br />0 <br />ste with any otherwaste that the total halides are fess ihan 1000 PPM. mid that the waste does riot contain <br />Norwd charges for legal disposal ff this, waste is over 1000 PPM; total halides, or contains any PCB's <br />i <br />1�a DRIVER SIGNATURE: _ <br />;UBJtCT TO A 1.5% SERVICE CHARGE CUSTOMER APAY ALL LEGAL FEES OF COURT <br />LECT THIS INVOICE <br />for that GenetaRars shipment of used oil may be transported. to a faciftty that is required to comply with federal <br />;ed OR.. Sur that is not rregttired to comply watrthe more stringent mgAmrnants apprix:able to hazardous waste <br />Ring is autitorved to file a request for EPA#from DISC. Ca[fomia fatxTdiess that handle or process used oil are <br />kements, and some out-of-state fiwilities that process used oil & also meet those requaements, engineering <br />assurances for clostus an accidental releases. It is Iaherlul to Send used oil to out-af�--Fate Fadmies that comply <br />lardsand notthose more stringent reqs Rements BY signing the i woicathegeneratorceBHiesthatihegeruNater <br />volume ar quantity and toxicity of the hazardous waste to the degree, as.detennined by generator, to be <br />)ningfhisinvoim if wiUserveas an agreemen"hatKem DO wifi submit confimntiom for(cmt3inwasfiesUeams) <br />e>sported to a lrc�raaed treatinerit oriransfer fatality. <br />❑ NAME NAME <br />ADDRESS ❑ ADDRESS <br />Cf TY CITY <br />STATE, ZIP STATE, ziP_ <br />PHONE PHONE <br />rrPa�tS�t i�P. ,C <br />FG% to --- — -- - - <br />