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Envlrommental Services Division
<br /> gy�a Malting:P.O.Bea 5T6,Salida,GA 9636e
<br /> EINC. 4612 Nteman Court,3111,11,CA 95769
<br /> !'052YU-IF INConsolidated Manifest Phane:2ae•546A791' �* IVO"`e SPAMCAfi000a4Te59
<br /> CA Tranapoder Wumbar 3844
<br /> CA tJun.e it 7585'18
<br /> GENERATOR: Invoice hl° 40 O0 17 5 0
<br /> Site EPA 13 .,[. 0006'�� 1-.1-Data: —�
<br /> Contact Person: Driver Primed Signature:
<br /> Nam v: l �, Truck 9:
<br /> Address: t ()T e, . NL
<br /> y. 2.f PC
<br /> CIty,Wate,.Zipr 5 G{. 5 L
<br /> Sita Phone:
<br /> product Shlptafng Name wu,W CA Manf(est 00 Rue1r unit, Price Amount '
<br /> Coda
<br /> Non-RCPAHzzarMiss Waste Llquld{Used 01¢:Lubdcstlng 221 &-E17 T� `Ci
<br /> Nen-RCRA Hazardous Waste Llquld{Used DO):lndusliial 225 0.1 ux
<br /> Non RCAAHa2ardousWa5le Liquid(Used Automotive AniUrea7e) 134 Gal 11f/j/
<br /> Non-RCRA Hatardd1la Waste Liquid(Oil&Wate) 223 Cal
<br /> Nan-RGRA Hazardous Wasle Solds ContaMlreted with Used 00 352 pram.)
<br /> Paper andfor P4ssGc Ot Kier Drum(s) 352 pramt:)
<br /> Poch
<br /> Drained Used Oil(Metal)Rller 01um(s) -
<br /> Each
<br /> FmplyOntm(s)
<br /> Trdrbpoflalion 1 Tru&71me PP'
<br /> urdeesathMwis.apeal6ea aaqus Canselldetetl Mmlbat Recent pavmao)7emre A—tsdaennlheloarof the moron fallowln0 month olpuv llae.a.Pest duo Total
<br /> .w
<br /> Ito r1ra190a apiWANCECHARGE a tilt.PERI ODIC RATEar1.1r2%'par1wIh,whichis Ina ANNUALPERCErr7AGE RATE.r19%.
<br /> By signing I hereby eerily that I have rpt mired any of the,male descnbed above Wth any other hazardous waste,the totel halide contort Is LESS than 1,000 ppm,and
<br /> tha mate does not contain any PCB's.I have complied with the requiremerds of the aPPlipbEe CallFemla used oil management regulation to detttnnlre this Is hue.I alree
<br /> to accept the additional charges for the disposal of tta waste if the Information I have provided about this waste islnoomect.
<br /> GenaretpYs Ceriigtahon;By s}gning I rerOty that 15 I eZr,,large quantlty!:eml.r,I®rbfy that I have program In place to reduce the volume and Endalty of waste
<br /> generated to Ma degree I have determined la be ecorwiaa0y afromable and that E have selected the pm orwable,me"d treatment.storage,or dlsposal wmenny
<br /> avaltabio to me which minimizes the present and future threat 1.human fife and the environmanl.Or,If l am a small quantity genomror,I haw made a Good ro dh effort m
<br /> minlm[ze my waste an.--,antl select thu waste management rrmethud that IS evallab[a to me]hot I cart afford.
<br /> George W.Lowry,Ina hereby advise.the above Generator that genamiars shipment or Used Oil and OIIy7Water may be transported to a facility that is mquired to comply
<br /> w,llr federal ragola6nns apptloabl.m management of Used Olt and OgyM+ater,but that is not required to comply witll the more stringent requ[mments app0mble to
<br /> heurdous waste management la s.c7lomiafacilities that handle or praoase Used Oil and Oily/Water ora required to meet Mose mora stringent raqulrements.and
<br /> soma a rof-state fociElfles that process Used Ori and OfiyNrratar also moat those mqulraments,engineering cernfictions of tank Integrity,and financial assurances for -
<br /> Uesure and aWdentW releases,It 1s mwrul b send Used Oil and OilyNuater to out of slate facilities that comply only wfth federal Used 09 and OPyNVater manag.rrent
<br /> standards and not Ihesa more stringent requirements. ,
<br /> This noOHration Is for the Informational purposes any.
<br /> By both parties signing this involaa It will serve as an that 9 ,Eric.will submit ocrin"011m for(cartain waste streams)to the penaretar that Melr
<br /> waste has been transponad to a permitted transfer I permi go or dlspo0al faculty.
<br /> Lowry Driver Signature X ate
<br /> Signature of Generator,Repreae t Gr Agent of nerator. X Date
<br /> ame:❑ Recycling,Transfer,Treatment;Storage,Disposal Facilities Is—
<br /> E3
<br /> � .f ❑ E3 Adds..: ,
<br /> sakesputd Transfer r Laliforau CIf T..fee LLC Ramer Envlmnmental Sakti Oil Recycling.lnc, City,train,710:
<br /> 4620 E Brundage Wn 9790 Claus Road 15155,61ver Road 1217 S.Resta Ave, ph.
<br /> Baftmsfleld,CA 933117 Riverbank,CA 95357 West Sacmmuata,CA 85661 Parker,Ay 95341
<br /> rs1,1224M 209-B63-0191 91631tS147 928-0 -2
<br /> 5442 SPAIM '
<br /> CALM2825911 CALAOe190916 CADD44003556 AZ.R000519181
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