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tnvironmemdi aei vwee--vn ��- Mailing:P.O.Box 176,Salida,CA 95368 �� 4612 Kiernan Court,Salida,CA 95366 '"C• Consolidated Manifest Phone:209-545-0791 FAX 209-545-2241 K LO�V RY EPA#CAR000047019 R PETROLEUM PRODUCTS COMPANY I nvo ice CA Transporter Number 3644 at#758518 GENERATOR: ' e Nd 0 ;Inv Site EPA ID#: voice Date: Contact Person: S Driver Printed Signature: Name: Truck#: Address: PO# City,State,Zip: Site Phone: TERM Product Shipping Name Waste CA Manifest#0 Quantity units Price Amount Code Gal Non-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221 Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal N Hazardous Waste Liquid(Oil&Water) Gal- --. - 11 Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(s) Drum(s) Drained Used Oil Filter Drum(s) ��. . f Each Empty Drum(s) HR. Transportation&Truck Time Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms: Accounts due an the 101h of the month following month of purchase. Past due Total } - accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%per month,which is the ANNUAL PERCENTAGE RATE of 18% t; By signing i hereby certify that I have not mixed any or 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 addltionat charges for 1ha 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 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 envlmnmenl.Or,if I am a small quantity generator,I have made a Good Faith effort 10 minimize my waste generation and select the waste management method that Is available to ma Thal I can afford. George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and OilylWatar may be transported to a facility that is required to comply with federal regulations applicable to management of Used Oil and OilylWater, but that Is not required to comply with the more stringent requirements.applicable to hazardous waste management facilities.Califomia facilities that handle or process Used 011 and Oily/Water are required to meet those more stringent requirements,and some out-of-state facilities that process Used Oil and 011yANater 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 Oilymater to out of state facilities that oampty only with federal Used 0)1 and OIIyNVater management standards and not these more stringent requirements. This notification is for the informational purposes only. By both parties sign)ng this invoice it will serve as 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 permitted transfef faClttlity or permitted treatment,storage or disposal facility. �`•, Lowry Driver Signature X a f Date _ I ; Date , — Signature'of Generator,Representative or Agent of Generator: x - , Recycling,Transfer,Treatment, Storage, Disposal Facilities Name: ❑ ❑ .Address: Bakersfield Transfer CaEifomia Oil Recycling Ramos Environmental Yuma Environmental City,State,Zip: 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th phone: I Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 661-322-8258 209.863-8181 916.371-5747 928-344-9826 EPA ID: CAL00028258 CAL0000190817 CAD004003556 AZR000515924