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W4AI <br /> Send Payment To: <br /> 2355 Road 192, Delano CA 93215 <br /> OPh : 2O9-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000363253 ID # 77-0379490 <br /> Job Site . LIC.AND INSURED TRANSPORTER#3468 MCP# CA 130615 <br /> GENERATOR <br /> Site EPA ID# Invoice No. F W <br /> Contact,Person <br /> Company Name , ^ " Bill TO <br /> Address ! ,) rTm . iii.# Name <br /> City, State, Zip 4j L .lu -'' 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(Useq Oil) 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil 8 Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Useq Automotive Antifreeze) 133 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated Drum(s) <br /> Drum(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil <br /> Drained Used Oil Filter Drum(s) Drums(s) <br /> Eaac <br /> Empty Drum(s) <br /> Transportation&Truck Time&Washout HR. <br /> Hazardous Testing <br /> We pay ❑ Customer Pays ❑ <br /> Unless otherwisef,; <br /> his Confbec <br /> anifest Receipt(Invoice)Terms:Accounts due on the 10th of the month following Total <br /> month of purchasccountsrged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which is the <br /> ANNUAL PERCEOF 18 <br /> 1 hereby certify tt mixeste with any other waste that the total halides are less than 1000 PPM,and that the waste does not contain <br /> any PCB's. I furtaccepitional charges for legal disposal If this,waste is over 1000 PPM,total halides,or contains any PCB's <br /> GENERATOR o <br /> AUTHORIZED : <br /> DRIVER SIGNATURE <br /> TERMS: INVOICES OVER 30 DAUBJECT TO A 1.5%SERVICE CHARGE CUSTOMER AGREED TO PAY ALL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARYLECT THIS INVOICE. <br /> Kern Oil here by advises the abovtor that Generators shipment of used oil may be transported to a facility that is required to comply with federal <br /> regulations applicable to management o'used oil. But that is not required to comply with the more stringent requirements applicable to hazardous waste <br /> management facilities. Kern 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-state facilities that comply only <br /> with federal used oil management standds and not those more stringent requirements By signing the invoice the generator certifies that the generator has <br /> established a program to reduce the vollme or quantity and toxicity of the hazardous waste to the degree,as determined by generator,to be economically <br /> practicable.By both parties signing this innice it will serve as an agreement that Kern Oil will submit confirmations for(certain waste streams)to the generator <br /> that theirwaste has been transported to a I�cenced treatment or transfer facility. <br /> ❑❑ NAME ❑ NAME Riverbank Oil Transfer ADDRESS <br /> 5300 Claus Rd,Bldg 11 ADDRESS <br /> Riverbank,CA 95387 CITY CITY <br /> Ph:209-863-0888 Fax:209-863-088 r STATE,ZIP STATE,ZIP <br /> EPA#CAL00o190816 PHONE PHONE <br /> EPA ID EPA ID <br />