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environmental5ervicas Division Malling:P.O.sax 17%5aeda,CA 95311 - �'✓I�INC. 461 Z soman Court'9alltld,CA9595s Consolidated Manifest Phone:apr645-0791 FA Znee45-2241 InVO'� WA/CARgg6667019 Invoice 1I `LEVM PpOe V CSg C CA T—pertor Number 3844 �. off` CA 1,1-..C7586+,8 4 � I GENERATOR: Invoice NO 40o o 12 18 I i SIM EPA fo M: d0Sa Invoice Oats: —!� r ih i Contact Person: Driver Printed Signature: Name: r7 Truck 9: 4 Address: !•,- Z. t f ,� pOul .. City,State.Zip: V I Site Phone: — TERR05 ;111. Product Shipping Nantaw'�oe C,4.Manllestp0 Quanliry V.I. Price Amount pp i V/ 1c I� Norl*CRA Hazardous Waste Liquid(Wed Oily Lubncaling 221 1 1� Lit ZZ,5r cal Non-RCRA Hazardous Waste Liquid(Used Oil):Industrial 221 cm i h Non RCRAHazardous Waste Liquid(Used Automotive Antifreeze) 134 Nm-RGRA Hazardous Waste Liquid(011&Water) 723 Gsl yJ., I. Non-RCRA Hazardous Waste Solids Donlamiratad w10 Used 00 757 PapwanlddrPIosgo011Filter Crum(s) 352 oremtsl pralrred Used Oil(Halal)Flier Dn m(s) Each Empty Orum(s) _ Each TrenslAdatlon&Truck Time RR sir j Ilu¢5p onwmieupeelrretlrnads GenwlHa[etl MannooERaraiplllnvoa:o)i e:A¢ounts dupwUte t0lher Ne month fp6pwing menu,of purtheea.Pa6rdu9 Total `I euaunts M1 he chapel a FINANCE CHARGE at the PERIODIC RATE of 1-ih%,per mmlh,which>a mo ANNUAL PERCENTAGE RATE W la%. 1 sy signing I hereby eEdify that I have not mrxed any of the waste descrthed above wide any other hazardous wrest.,the total hAtid.convent is LESS than 1,0gd ppm,and the waste does not centoin any PCAs.1 have complied with the mquiremaols of the apptica Ne CalifUmlo used of managementraguiatton to de<enNne this✓b true.l agree ;{ r to adeeptthe additional thargss for the disposal of the waste C the in—ficin I have pmwided about INS waste Is inwnecl 41 Generators Co Vcation:By signing I oddly that If I am a large quantity generalor,I ce+dh that I have yragram in place to redtrce the volume and TcAdty of waste generated to the degree I have determined to be econamieally affordable and that I have selected Ne practirablo method of treatment,storage,or dlspnsat currently It availableto me which minims=the present and future threat W human Itfe and Cts environment Cr,if I am a smali qumdity gon.raton I have made a Good Faith egort to minimize my ween generation 2nd Wed the waste management method that Is awfiahle W me that I son afford. Gaprge W.Lawry.Inc.hereby advlses the above Generator that generators shlpmenL of Used Ol and OIIyiWat.r may be transported to a facility Ihet is required to comply with federal regulations applicable to managamord of Used Gil and Oily/Water,but uul Is rat required to comply wt01 the more sln'nge 1.requirements applicable to hazardous wastemanagement facilities.Cadlomia faolillas that hardle or process Used Oil and 011y7Wator are required to meet(hose more stringent requirements,and some oataesWe ZRINes that process Used Op and OiiyMlater also meet those requirements,ungrnaering oertirl at[ans of lank integrity.arrd financial assurances for closure and-Culdentel releases.It Is IawU to sand Used Oil and 011 M.ht,W out of slate fadut4s that comply only with federal Used Oil and 011yfWater management standards and not these more sLringenk requtrementc. This rahti5palion is far the informational purposes uNy. By both parties sigNng this Involve It ran serve as an agrrgge..nil Npwry,lnc.Wpl submit confirmation for(csitain wast.streams)to the generator ihot their wristv has been transported in a permitted barwferto lift'or It Q V tment,storage ordleposa!fadlity. 4h Lowy Driver Signature70 D Signatrt+e of Generator,Repra ive ar nt of Generator: % Date Recycling,Transfer,Treatment,Storage,Disposal Facilities Nw„w I r ❑ ❑ ® ❑ Addrnea: 8&d'leid7ransfar California 011 Transfer LLC Ramos Erevmnmealal Bak.OU Recycling,Inc city,etam,ap: lizo E.Brandago inn. 5309 Ciaos Road 15155.Rlvor 11.0 12175.FiesmAve- li'l'—fidd,CA 93307 Riverbank CA 95361 West Sacramento,CA P5691 Parker,AZ 65544 ph... 601az1-6258209-863.8161 916-371-5747 926-6543202 CAL0082e2598 CALOOD190616 CA0044003556 AZR000516161 EPAIO: