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Environmental Services Division Mailing:P.O.Box 176,Salida,CA 95368- GEORIGGIEwc. 4612 Klarnari Court,Salida,CA 95360 .!_!?r C6 h sio`l i d a t e Manifest Phone:209445-0701 FAX209-545-2241 W.LOWRY qAPETROLEUM PRODUC"COWPI�Ny Invo ce EPA*CAROuoo,17019 CA Transporter Number 38d4 CA License#750518 GENERATOR: Invoice NO 4V: Invoice Site EPA 10 M Invoice Date-, A Contact Person:- Driver Printed Signature: -S c4p—7Fe Name: Truck Address. 10� PO City,State,Zip: Sita Phone: 1�31 5 TERMS. Product Shipping Name Waste �A Manifest#0 Quantity units Price Amount Code Non-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221Gat lit. Non-RCRA Hazardous Waste Liquid(Used 00): Industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 GM Non-RCRA Hazardous Waste Liquid(01)&}Nater) 223 Gal Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drained Used Oil Filter Drum(s) Empty Drum(s) Each Transportation&Truck The Unless otherwise spedfied on this Consolidated Manifest Receipt(Invoice)Teras:Accounts dtie'unthe 101hol'the month following month of purchase. Past due Total accounts YAII be charged a FINANCE CHARGE at the PERIODIC RATE of 1.1/2%per=nth,which is the ANNUAL PERCENTAGE RATE of 131/0. By signing I hereby cerUty that I have not mixed any of the waste described above with any other hazardous waste,the tots]halide content is LESS than 1,000 ppm,and the 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 accept the additional charges for the disposaf of the waste if the information I have provided about this waste is incorrect. Generator's Certification: By signing I certify that If I am a large quantity generator,.) certify that I have program in place to reduce the volume and toxicity of waste 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 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 F�sith effort to minimms my waste generaton and select the waste management method that is available to me that I can afford. George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and Oily/Water may be transported to a facility that is required to comply with federal regulations applicable to management of Used Oil and OilyPNatar, but that is not required to comply with the more,stringent requirements applicable to hazardous waste management facilities.California facilities that handle or process Used Oil and Oily/Water are required to meet those more stringent requirements,and some out-of-state facilities that process Used Oil and Otlyfflater also meet those requirements, engineering certifications of tank Integrity,and financial assurances for closure and accidental releases, It is lawful to send Used Oil and Oily/Water to out of state facilities that comply only with faclerai Used Oil and OiIYNVatermanagement standards and not these more stringent requirements. This notification Is for the informational purposes only. By both parties signing this Invoice it will se"O as arl'agreeirnent that George W.Lowry,Inc. will submit confirmation for(certain waste streams)to the generator that their waste has been,transported to a permitted t6nsferilfacitlVoi:,,permltted treatment,storage or disposal facility, Lowry Driver Signature X Date Signature-of Generator,Representative or Agent of Generator; X Date Recycling,Transfer,Treatment,Storage, Disposal Facilities I Name: L M, . 'I 0 13 Address: Bakersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental City,State,Zip., 1620 E.Brundage Lane 5300 Claus Road 1515 S,River Read 2730 E.13th Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 96591 Yuma,AZ,8$365 Phone: 661-322-8258 209-863-8181 916-371-5747 928-344-9826 r,ALOD028258 CALOGOO190617 CAD004003656 AZR0085I5924 EPA 10: J