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b i Environmental Services Division MRlling:P.O.Box 176,Sallda,CA 95368 4612 Kiernan Court,Satida,CA 95358 Consolidated nifest Phone:204.545-0751 FAX2U8-545-2241 CGEORGEIINC M PRODUC'PS COMPANY.. I[1 V o�ii c L EPA#CAR06004781s v CA Transporter Numbor 3844 CA Licensa#758518 GENERATOR: invoice N° 40:; Site EPA it)#: ! invoice Date. Contact Person: 4Z Driver Printed Signature: Name: Truck#: Address: ( : ";'t PO# City,State,Zip Site Phone: 20 17 , -� TERMS Product Shipping Name .Waste CA Manifest#0 Quantity units Price Amount Code Non-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221 -r Gal ; Non-RCRA Hazardous Waste Liquid(Used Qii): Industriai 221 Gat Non RCRA Hazardous Waste Liqufd(Used Automotive Antifreeze) 134 Gat Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 cat Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drums) Drained Used Oil Filter Orum(s) Oromisl Empty Drum(s) Each Transportation&Truck Time WR, Unless otherwise specified on this Consolidated Manifest Race pi(Invoice)Tarns:Accounts due on the 101h of the month foiloWng month of purchase. pass due Total a:J' accounts w€1€be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%per month,vrhich is tho'ANNUAL PERCENTAGE RATE of 18%. 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.1 have compiied with the requirements of the applicable California used oil management ragulallon to determine this is true. €agree to accept the additional charges for the disposal of the waste if the Information 1 have provided about this waste is incorrect. Generator's Certi€ication: 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 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 Iraith effort to minimize my waste generation and select the waste management method that{s available to me that I can afford. George W_Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and 09y/Water may be transported to a facility that is required to comply with federai 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 facilities.California facilities that handle or process Used Oil and Oily/Wator are,required to meet those more stringent requirements,and some out-of-state facilities that process Used Oil 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%and O€lylWater 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 invo(ce it wili serve as an agreement that,•Qeorge' f Lawry,Inc, will submit confirmation for(certain waste streams)to the generator that their waste has been transported to a permitted transfer facility or penriitted tteatiiient,storage or disposal'facility, Lowry Driver Signature X pate 1.. Signature of Generator,Re resentativ,+K.o Sgan g A t of Generator: X date Recycling,Transfer,Treatment, Storage,Disposal Facilities Name: °r - € Address: �,h 1 1 Bakersfield Transfer Callfornl'a Oil Retycling Ramos Environmental Yuma Environmental city,state,Zip; 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th &akereffeld,CA 93307 Riverbank,CA 96357 West Sacramento,CA 95691 Yuma,AZ,85365 Phoria: 661-3224258 209-863-8181 918.371.5747 928-344-9826 CALD0028258 CALDDD019081 =; CAD004D035% AZRD00515924 EPA ID: