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r!3� <br /> Jab Site : 2355 RD. 192 DELANO, CA 93215 <br /> GENERATOR Ph.: (209) 863-0888, FAX (661) 725-0654 <br /> 1D# 46-0727047 1 CAL000367042 <br /> Site EPA ID# LIC.AND INSURED TRANSPORTER#3498 <br /> Contact Person Invoice NO. MI �b b 7 <br /> Company Name > r— Bill To <br /> Address Name <br /> City, State, Zip -y 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 Code CA Manifest# Quantity Units Price Amount <br /> Non Hazardous Waste Liquid(Used Oily 221 r 'l�J fp s /�'601'_ S` Gal � ` <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gat <br /> Non•RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal <br /> Nan-RCRA Hazardous Waste Solids Contaminated Dw(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil TrU—M(S) <br /> Drained Used Oil Filler Drum(s) - - lJNfits(S� <br /> Empty Drum(5) Fd <br /> Transportation&Truck Time&Washout HR. <br /> Hazardous Testing <br /> We pay❑ Customer Pays. <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the month following Total <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERFOdIC RATE of 1.5%per month,which is the <br /> ANNUAL PERCENTAGE RATE OF 18°I. <br /> I hereby certify that I have not mixed this waste 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 further agree t ;accept the additional,charges for legal disposal If this,waste is over 1000 PPM,total halides,or contains any PCB's <br /> GENERATORor <br /> AUTHORIZED� DRIVER SIGNATURE <br /> TERMS:INVfltCE OVER 3kDAY,9 ARE SUBA7 TO A 1.5%SERVICE CHARGE CUSTOMS REED TO PAY ALL LEGAL FEES OF COURT <br /> ACTION BECOMES NECESSARY TO COLLECT THIS INVOICE. <br /> Kern Oil here by advises the above Generator that Generators shipment of used oil may be transported to a facility that is required to ccmpiy with federal regulations <br /> applicable to management of used oil.Butthat Is not required to comply with the more stringent requirements applicable to hazardous waste managementfacililies. <br /> Kern oil Filter Recycling is authorized to file a request for EPA#from DTSC.Califomia facilities that handle or process used oil are required to meet those more <br /> stringent requirements,and some out-of-state facilities that process used oil&also meet those requirements,engineering certifications of tank integrity,and financial <br /> assurances for closure an accidental releases.it is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards and <br /> not those more stringent requirements By signing the invoice the generator certifies that the generator has established a program to reduce the volume or quantity <br /> and toxicity of the hazardous waste to the degree,as determined by generator,to be economically practicable.By bath parties signing this invoice itwitl serve as an <br /> agreement that Kem Oil will submit confirmations for(certain waste streams)to the generator that their waste has been transported to a licenced treatment or transfer <br /> facility. <br /> Califarnla Oil Transfer ❑ BT1 ❑ ❑ NAME <br /> 5300 Claus Rd,Bldg 11 1620 E Brundage Ln ADDRESS <br /> Modesto,CA 95357 Bakersfield,CA 93307 CITY <br /> Ph:209-863-8181 CAL0002132598 STATE,ZIP <br /> Fax:209-863-8171 PHONE <br /> EPA#CAL000190816 EPAID <br />