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Job Site <br />EPA 9 CAL000367042 <br />LIC. ANq INSURED TRANSPORTER # 3468 <br />Send Payment To: <br />2355 Road 192, Delano CA 93215 <br />Ph: 20M63-0888 - Fax: 209-863-0887 <br />I D # 46-0727047 <br />MCP# CA 130615 <br />GENERATOR <br />,t �, 6< <br />Invoice No. t 6 iB <br />Bill TO: <br />Site EPA ID# L; <br />Contact Person <br />Company Name( ) - a 1� <br />Address J� d { Q , <br />Name <br />City, State, Zip <br />dress <br />Site Phone <br />City, State, Zip <br />Date <br />W) <br />Custc mer PO <br />interval <br />Net 30/C.0.D./Cash/Check <br />�yDrivers Truck/Name <br />PRODUCT <br />Code <br />CA Manifest # <br />Quantity <br />Units <br />Price <br />Amount <br />Non RCRA Hazardous Waste Liquid (Used Oil) <br />221)2(� <br />'z <br />Gal <br />, 5-0 <br />%q 0O , <br />Non-RCRA Hazardous Waste Liquid (Oil & Water) <br />223 <br />Gal <br />Nan-RCRA Hazardous Waste Liquid (Used Autlilmotive Antifreeze) <br />133 <br />Gal <br />Non-RCRA Hazardous Waste Solids Contam ted5) <br />Non_RCRA Hazardous Waste Solids Contain' ed with Used Oa <br />mss) <br />Drained Used Oil Filter Drum (s) <br />_!Sl <br />Empty Drum (s) <br />Transportation & Truck lime & Washout <br />Hazardous Testing <br />We pay ❑ Customer Pays <br />Unless otherwise specified on this Consolidated rfest Receipt (Invoice) Terns Accounts due on the 10th of the month foilowing <br />month of purchase. Past due accounts will he chaMrd a FINANCE CHARGE at the PERIODIC RATE of 1.5% per month, which is thea <br />ANNUAL PERCENTAGE RATE OF 18%. I A <br />Tota) <br />TTT 0 �� <br />IN <br />U <br />I hereby certify that I have not mixed this wastO with any other waste that the total halides are e s th 1000 PP Lthat waste does notcontain <br />any PCt3's. I further agree to accep the additional charges for legal disposal If this, waste is 1 �PM, tot ntains arty PCB's <br />GENERATOR or i <br />AUlHORIZED:— " DRIVER SIGNATURE: <br />TERMS : INVOICES OVER 30 DAYS ARES EJECT TO A i.5°h SERVICE CHARGE CUS ER O PAAL FEES OF COURT <br />ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br />Kern Oil here by advises the above Generatoil 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 usel oil. But that is not required to comply with the more stringent requirements applicable to hazardous waste <br />management facilities. Kern Oil Filter RecyclirIg is authorized to file a request for EPA# from DISC_ California facilities that handle or process used oil are <br />required to meet those more stringent requirenents, and some out-of-state facilities that process used oil & also meet those requirements, engineering <br />certifications of tank integrity, and financial as$urances for closure an accidental releases. It is lawful to send used oil to out-of-state facilities that comply <br />oniywith 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 the degree, as determined by generator, to be <br />economically practicable. By both parties signi�g this invoice it will 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 licenced treatment or transfer facility. <br />6RK�'bank Oil Transfer NAME NAME <br />5300 Claus Rd. Bldg 11 ADDRESS ADDRESS <br />Riverbank, CA 95387 CITY CITY <br />Ph:209-883-0888 Fax: 209$63-0887 STATE, ZIP — _. ___ STATE, ZIP— <br />EPA#GALVoo190a16 PtIONE _—_ PHONE <br />EPA to EPA IC <br />