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Environmentjl Services Division
<br /> Mailing:P.O;' ox 176,Salida,iCA95368
<br /> INC. Consolidated
<br /> '► n ,J Manifest " 4612 Kiernan Curt,Sends,CA 9¢368
<br /> Co isoli a .ed Manifes Phon'ei:,2095�5A791 FAX 209545.2241'
<br /> ® Invoice,
<br /> a,®i�Q EPA#CAROp'047019
<br /> qEOR .7E
<br /> OLBUM PRODUCT8 COMPANY V �r 4
<br /> CA Transport it dumber 3844
<br /> CA LI, # 58598
<br /> GENERATOR: Invoice R w
<br /> Site EPA ID#: t t Invoice Date;
<br /> Contact Person: Driver Printed
<br /> Signature:
<br /> �I
<br /> Name r Truck# W
<br /> Address
<br /> City,State,ZIP.
<br /> a
<br /> di
<br /> Site Phone: TERMS: j1 i
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<br /> Product Shipping Name code' CA Manifest#0, i Quantity,' Unit Price i Amount
<br /> Non-RCRA Hazardous Waste Liquid(Used.011):Lubricating 221 . ; Gal
<br /> M .
<br /> Non-RCRA Hazardous Waste Liquid(Used 011): industrial 221 aai
<br /> ' i
<br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gail
<br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 oai
<br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Dru{n( >`
<br /> Drained Used Oil Filter Drum(s) Dru'n(')
<br /> Empty Drum(s) Eaon°
<br /> Transportation'&Truck Time H .
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<br /> I I
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<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 i ' TotaI
<br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-112%per month,which Is the ANNUAL PERCENTAGE RATE of 18%. i
<br /> a?
<br /> 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 11,000 ppm,and the
<br /> waste does not contain any PCB's,fi have complied with the requirements of the applicable California used oil management regulation to determine this is true.1 agree to
<br /> accept the additional charges for the disposal of the waste if the information I have provided about this waste is Incorrect. 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 thew lume and toxl jity of waste
<br /> generated to the degree I have determined to be economically;affordable and that I have selected the'practicabie method of treatment,st�rag'e, or,disposal current)
<br /> 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 hate ads a Good Faith effort to
<br /> minimize my waste generation and select the waste management method that is available to me that I can afford, �" i f
<br /> George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and OIIyMater may be transported!to a fa�ili y that Is required to comply
<br /> 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
<br /> hazardous waste management facilities.California facilities that handle or process Used Oil and Oily/Water are required to meet those mo, tringent iequirements,and
<br /> some out-of-state facilities that process Used Oil and Oliy/Water also meet those requirements,engineering certifications oftank'integrity�;a d financial assurances for
<br /> closure and accidental releases,it Is lawful to send Used011 and OIIy/Water to out of state facilities that comply only with federal Used Oills d diiyMpter in anagement
<br /> standards and not these more stringent requirements.
<br /> This notification is for the informational poirposes only,
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<br /> By both parties signing this Invoice it will serve as ari agreement that George W.Lowry,Inc. will submit confirmation for(certain waste streams) o the generator that their
<br /> waste has been transported to a permitted transfer facility or permitted treatment,storage or disposal facility. a
<br /> Lowry Driver Signature X f � � Date'
<br /> Signature of Generator,Represai ative or Agent of Generator: X '
<br /> ' , .ate
<br /> Recycling,Transfer,Treatment,Storage,Disposal Facilities Name;
<br /> 13 ® Address
<br /> (..
<br /> Bakersfield Transfer California 011 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 ` Phone:
<br /> 661.322-8258 209.863.8181 916.371.5747 928-344-9826
<br /> CALOOD28258 CALOOD01908T CAD004003556 AZR000515924 EPA ID:
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