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^� Environmental Services Division
<br /> tr 4 Mailing;P.O.Box 976,Salida,CA 95360
<br /> !��` Consolidated Manifest ,.4,§,2Klerna°°ourt,Salida,CA9536a
<br /> W,LOWRY
<br /> qAP9VROkEU1M
<br /> Phone:209.545.0791 FAX 209.545-2241
<br /> PRODUCTS COMPANY invoice EPA#CAR000047019.
<br /> CA Transporter Number 3844
<br /> CA License#758518
<br /> GENERATOR: Invoice N0- 4.0 n ; '} 1, .�
<br /> c t '!j
<br /> Site
<br /> Site EPA 1D#: Invoice bate:
<br /> Contact Person: G1 Driver Printed Signature:
<br /> Name:
<br /> "�
<br /> , } t i 'd, ',r �,a i Ic> Truck M ;
<br /> Address: 'E "'E< t
<br /> City,State,ZIP: j,r{, �; F
<br /> Site Phone: TERMS:
<br /> Product Shipping Name Waste CA Manifest#0 quantity Units Price Amount
<br /> Code
<br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221 Gal
<br /> Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 Gal
<br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal
<br /> {Von-RCRA Hazardous Waste Liquid(011&Water) 223 Gal
<br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 C"I{ `I y n` ( f Drum(s) t i
<br /> Drained Used Oil Filter Drum(s) Drum(s)
<br /> Empty Drum(s) Each
<br /> Transportation&Truck Time HR,
<br /> Unless otherwise specified on Ihfs Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the month following month of purchase. Past due Total
<br /> accounts will be charged a FINANCE CHARGE at the PERI=C RATE of 1-112%per month,which is the ANNUAL PERCENTAGE RATE of 18%.
<br /> By signing I hereby certify that 1 have not mixed any of the waste described above with any other hazardous waste,the total halide content is LESS than 1,000 ppm,and the
<br /> waste does not contain any PCB's.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree to
<br /> accept the additional charges for the disposal of the waste if the information I have provided about this waste is Incorrect.
<br /> Generator's Certification: By signing I certify that If I am a large quantity generator, I certify that I have program in place to reduce the volume and toxicity of waste
<br /> generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently
<br /> available to me which minimizes the present and future threat to human life and the environment.Or,if I am a small quantity generator,I have made a Good Faith effort to
<br /> minimize my waste generation and select the waste management method that is available to me that I can afford.
<br /> George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and OilyfWater may be transported to a facility that is required to comply
<br /> with federal regulations applicable to management of Used Oil and Oily[Water, but that is not required to comply with the more stringent requirements applicable to
<br /> hazardous waste management facilities.California facilities that handle or process Used Oil and Oify/Water are required to meet those more stringent requirements,and
<br /> some out-of-state facilities that process Used Oil and OilyAVater also meet those requirements, engineering certifications of tank integrity,and rfinancial assurances for
<br /> closure and accidental releases,it is lawful to send Used Oil and Oily[Water to out of state facilities that comply only with federal Used Oil and OilyMater management
<br /> standards and not these more stringent requirements.
<br /> This notification is for the informational pu*sesfonlyr
<br /> By both parties signing this invoice HI q 1
<br /> i� agreement that George W.Lowry,Inc, will submit confirmation for(certain waste streams)to the generator that their
<br /> waste has been transported to a perMitted trap4sf f�cility or permitted treatment,storage or disposal facility. 7
<br /> Lowry Driver Signature X , r: t Date 44 f, { it:. " _..
<br /> Signature of Generator,Representative or Agent of Generator: X 3 ii;, i '' " L. Date
<br /> Recycling,Transfer, Treatment, Storage, Disposal Facilities Name:
<br /> 13 13 Address:
<br /> Bakersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental city,State,zip;
<br /> 1620 E,Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th
<br /> Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95641 Yuma,AZ,85365 Phone:
<br /> 661-322-8258 209.863.8181 916.371-5747 928-344-9826
<br /> CAL00028258 CAL000019081& CAD004003556 AZR000515924 EPA ID;
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