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I nmental Services Division ailing:P.O.Box 176,Salida,CA 9536a GEORGIii 4:. 4612 Kleman Court.Salida,CA 95368 Consolidated M nifest Phone:2U9-545-0791 FAX209,545-2241 !r)WNI PETROLEUM PRYVF UC•r" o. IANy. Invoice EPA#CAR000047019 CA Transporter Number 3844 CA License#756518 GI=N BATOR: fnvo' e N2 40 Site EPA li]#: 1 ° Irvoi a Data: �; t Contact Person: G 1 Arly r Printed Signature; r W Name: f .. True Address: r L • PQ# a 5 7s N .- t- _ City,state,zip: s` _ Sits Phone: TER Product Shipping Name Waste CA Nlan€ st#0 Quantity Units Price Amount Code Non-RCRA Hazardous Waste Liquid(Used 011);Lubricating 221 ` # ( Gal Nan-RCRA Hazardous Waste Liquid(Used Cil); industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 car Non-RCRA Hazardous Waste Liquid(Cil&Water) 223 Gal Non•RCRA Hazardous Waste Solids Contaminated with Used Qii 3$2 ;_ti § s , oruaf(a) Drained Used(ail Filter Drum(s) Drum(s) E=mpty Drum(s) Each Transportation&Truck Time NR- i l3nless atherwfse specified on itris Consolidated Manifest Receipt{invoice}Terms:Accounts due on the 101h of the month foil ovAng month of purchase. Past due Tata1 - eccounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%per month,which is the ANNUAL PERCENTAGE RATE of 16%. By signing i hereby certify that I 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 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 disposal 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, I certify that I have program in place to reduce the volume and toxicity of waeta 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 Faith effort to minimize my waste generation and select the waste management method that is available to me that I can afford. George 4V,Lowry,Inc,hereby advises the above Generator that generators shipment of Us ad Oil and 011yMater may be transported to a facility that Is required to comply 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 hazardous waste management faciiitfes.California facilities that handle or process Used Oil and Clily[Water are required to meet those mare stringent requirements,and some out-of-state fachitlas that process Used Oif and Oily/Water 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 federal Used Oil and Oily/Water management standards and not these more stringent requirements. This notification is for the informational purposes only. By both parties signing this invoice it will serveras an agreement that George W.Lowry,Inc. will submit confirmation for(certain waste streams)to the generator that their waste has been transported to a perrrllttad trari8fe €acility or permitted treatmerit,storage or disposal facility. Lowry driver Signature X ;1 � Date ' = Si-9nature of Generator, Representative or Agent of Generator: X . pate ._...................___ RecycE1ng, Transfer,Treatment,Storage, Disposal Facilities € E €Name: y S ': .... ,: ❑ ❑ Address: 6aksrsf1old Transfer Caf€fornia Ott Recycling Ramos Environmental Yuma Environmental City,State,zip: 1520 E.Brundage Lane 5300 Claus Road ' 1515 S.River Road 2730 E.13th Bakersfield,CA 93307 Rtvorbank,CA 96367 West Sacramento,CA 85691 Yuma,Az,85365 Phone: 661.322-8256_ 209-863-3181 915,371.5747 928-344-982.6 CAL0002825 CAL060019084 CADD04003556 EPA ID: ,r.,: AZR0005i5924 i