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1Z, <br /> 20� <br /> Send Payment To: <br /> 2355 Road 192, Deland'CA9821, `��� <br /> Ph : 209-863-0888 - Fax : 209-863-0887 <br /> EPA#CAL000367042 ID#46-0727047 <br /> Job Site : LIC.AND INSURED TRANSPORTER#3468 MCP#CA 130615 <br /> GENERATOR A <br /> Site EPA ID# Invoice No. M <br /> Contact Person <br /> Company Name �'.'+' } A .I t1<< 'o ,,,_ BIII TO <br /> Address I L I Name <br /> City, State, Zip 1 (;(, Address <br /> Site Phone `"' C 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-RCRA Hazardous Waste Liquid(Used Oil) 221 Gal <br /> Non-RCRA Haz rdous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 Gal <br /> Nan-RCRA Hazardous Waste Solids Contaminated Drum(s) <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil Dnlm(s) <br /> Drained Used Oil Filter Drum(s) Dmms(s) <br /> Empty Drum(s) Ea51 <br /> Transportation&Truck Time&Washout HR. <br /> Hazardous Testing <br /> _ {Y <br /> l�t,t'1�� I c y 1 k~>�sG >1 t.- LA <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 <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which is the Total <br /> ANNUAL PERCENTAGE RATE OF 18%. <br /> I hereby certify that I have not mixed this waste with any other waste that the total halides are legis tharn,11000 PPM,and that the waste does not contain <br /> any PCB's. I further agree to.accept the additional charges for legal disposal If this,waste is over 1000 PP, total halides,or contains any PCB's <br /> GENERATOR or,-,,' / 'i <br /> AUTHORIZED: f C DRIVER SIGNATURE: ii-- <br /> TERMS:INVOICES OVER 30 DAYS ARE SUBJECT TO A 1.5%SERVICE CHARGE CUSTOMWkGREED TO PAYALL 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 comply with federal <br /> regulations applicable to management of 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 <br /> onlywith federal used oil management standards and notthose more stringent requirements By signing the invoice the generator certifies thatthe 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 signing 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 /> ❑ Riverbank Oil Transfer ❑ NAME ❑ NAME <br /> 5300 Claus Rd,Bldg 11 ADDRESS ADDRESS <br /> Riverbank,CA 95387 CITY CITY <br /> Ph:209-863-0888 Fax:209-863-0887 STATE,ZIP STATE,ZIP <br /> EPA#CAL000190816 PHONE PHONE <br /> EPA ID EPA ID <br />