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Envirlonmentel Services Division <br /> Mailing:P.O.Box j76,Salida,CA195368 <br /> INC. t4612'kleman Court,S'allda,iCA 9366 <br /> Consolidated M anifes 3 PhonQ:209545�07611,FAX209.5 5.2241 <br /> W,LOWRY UMRT8 <br /> CARD e1% <br /> OUCCOMPANY EPA <br /> ' <br /> CA Transporter�Ju�ir(�er 344 <br /> Invoice <br /> CA License#76 5� <br /> GENERATOR: Invoice ' ' b <br /> I <br /> r. 1 x <br /> Site EPA ID#: ;_ ; a Invoice Date: jl <br /> Contact Person: Driver Printed Sigha ur e <br /> Name : Truck#: <br /> Address ? PO <br /> City,State,Zips <br /> Site Phone: TEIRMS: , <br /> ; <br /> Product Shipping Name waste: CA Manifest#0 Quahtit k unit i <br /> Code Y i Prce Amount <br /> Non-RCRA Hazardous Waste Liquid(Used,011):Lubricating 221 P "' _ Gal; I <br /> i <br /> Non-RCRA Hazardous Waste Liquid(Used 0(1): Industrial 221 Gal; <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal' ! ; <br /> i <br /> Non-RCRA Hazardous Waste Liquid(011&Water) 223 Gal ' <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 DrumO <br /> Drained Used 011 Filter Drum(s) Drum(§) <br /> Empty Drum(s) Eachi r {' <br /> Transportation&Truck Time HR, j <br /> I i <br /> l ' I <br /> A <br /> l I <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms: Accounts due on the 10th of the month following month of purchase. Past`due ; Total 1 <br /> 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%. <br /> I i <br /> By signing 1 hereby certify that I have not mixed any of the waste described above with any other hazardous waste;the total hallde content is LESS than 1,000 ppm,and the <br /> waste does not contain any PCB's.,I have complied with the requirements of the applicable California used oil'management regulation to del e ming thi Is true.I agree to <br /> accept the additional charges for the disposal of the waste if the Information i have provided about this waste is incorrect. <br /> 1 I <br /> 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 vgiulina and toxicity of waste <br /> generated to the degree I have determined to be economically affordable and that I have selected the practicable,method of treatment, storage, or dispoal currently <br /> available to me which minimizes the present and future threat to human life and the environment.Or,if I am a small quantity generators I have made a Good alth effort to <br /> minimize my waste generation and select the waste management method that is available tome that i can afford. I' <br /> George W.Lowry,inc.hereby advises the above Generator that generators shipment of Used Oil and OilyMater may be transported to a facility that is l�equil to comply <br /> with federal regulations applicable to management of Used Oil and Oily/Water, but that is not required to comply,with the core 16tringenti requirements pplicable to <br /> hazardous waste management facilities.California facilities that handle or`process Used Oil and Oiiy/Water are required to meet those more stringent requirements,and <br /> some,out-of-state facilities that process Used Oil and,Oily/Water also meet those requirements, engineering ce(tlflcations(fof tank integrity;and fin <br /> assurances for <br /> closure and accidental releases,it is lawful to send Used Oil and Oily/Water to out of state facilities that compiy?only with federal Used Oil ad�011y/Water Management <br /> standards and not these more stringent requirements. <br /> This notification Is for the Informational purposes only.- <br /> t <br /> By both parties signing this Invoice It will serve as'an agreement that George W.Lowry,Inc, will submit confirmation for(certain waste stream o the generator that their <br /> waste has been.transported to a permitted transferfacilityor permitted treatment,storage or disposaLfeellity. <br /> Lowry Driver Signature XDate <br /> if' -� <br /> i I i <br /> Signature'of Generator,Rept es ntative or Agent of Generator: X Ilaid <br /> Recycling,Transfer,Treatment,Storage, Disposal Facilities Name; <br /> i <br /> En 13 13 E3 <br /> 1 Andress:' <br /> I if <br /> Bakersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental City,state,zip: <br /> 1620 E,Brundage'Lane 5300 Claus Road 1515 S.River Road 2730 E.13th <br /> Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 1 Phone: 1 <br /> 661.322-8258 209.863.8181 916.371-5747 928-344.9826 <br /> CAL00028258 CAL0000190817 CAD004003556 AZR000516924 EPA ID: <br /> i <br />