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. , trAny�au�az <br /> . P.0051006 <br /> * R <br /> bauing:110.aoR 176,%k46 cA 015888 <br /> 1032 WOMAD CtaUM$00,CA MOI <br /> Gec 9 W. Lowry, Inc, Phanr.209-MM701 FAX209.s4sa241 <br /> EnvrronmanW tianrlcse Dlvr&Ion VPA#CAR00004Y610 <br /> r..s►•rirangertar Number 3$" <br /> tJ Lleanaa!7aasla <br /> GENERATOR: <br /> Cottsolldatod Maniiast invoke; - t , <br /> I <br /> ContaetPerson: shlpmontDate:'%, moi. '/.. <br /> • L •r a Driver Signature(Printed): ' <br /> , �•l . <br /> Addrasa: i' r <br /> Truck# <br /> i+r , <br /> 8I4 Phone. PO# <br /> t' <br /> Product Waata CA I�'taOW#0 otrarrnty Ir,reR Price Jl,rrouM <br /> CotN <br /> Nwi.RCRA Hamrdous Wane tlquid(deed N d.ub►icaft Z2t '`' �'� Z <br /> 1 <br /> Non.RCRA Flamed w Waste L4uld(Used 0�:htdtrat w 221 <br /> Non RCRA Huardotz WaAB I WU(Und Aut moftAr6wze) 114 tear <br /> NWACRA liazerdan Waste up,id p s Water) 223 <br /> Non•RCRA <br /> Harardoas Waste Solids Ctxtiamlisatad wlh thrad Ot! 155 <br /> a <br /> Dra4led Used OA FNler Dnan(s) Orum(s) " <br /> Effft D"h) <br /> F.aari <br /> Tramp 11135Dn I Tnrdt Time <br /> HR. <br /> Hazardous Test <br /> Ikilna aaun tae on any CanMseaya 1lsnrhq R*34 t la )Trap:Acmura dna an vw 10e�at s,a morgn >a aionTh of perdwaa.Pnt a,s 1! _(11' <br /> +moima wrs De aAfrpW a FNlArrCl:CIrARflE at tiv PEAIOOIC RATE o<7 1r2ri par mcnR u+ii�h ti ar ANNUAL PERCEH7AiJE RATE d 1914 TOW ' 11,1�-•r <br /> By signing this receipt,the Oanaratarcer8fles that a prWram has been estabUshed to raduoe the vdwne or ff <br /> determined try tM generator,to be eoonomt *W dk.W. quan*and kWdty of the hmrdous was#s tD a degras as <br /> Generator clnllres aw all Heiar =Waste balsa on ft CorWWW4ted t4lanl ak Ret dpi is Proms to meal the Waste Codas as U Wd abovd <br /> Note: George W. Lowry,Inc. hereby advises the Generator that X <br /> not requi ed used a0 may be transported to a fadity that la required to com ,wgfi 'e(Generator's signature) <br /> not required t0 Comply vrith the mora piy m vms l tOguladone applicable to ma^agement of used oil but that is <br /> process used oil ars _°Mom M raquirertrants sp[ranwe to and waste management , Calirlomla that handle or <br /> Monte These include mom atringertt leak deb"onyandpr mqulnsrr aqui,and aand out-0f�lete'od that PMW56 used oN AM meat those requira- <br /> for closure and accidentsl rebases, It Is W04UI to send used o^ll ttoo^out of stats fadreftma,"40""ffles �"Of"inEasrldr;and ImWal assurances <br /> dards and not these more stringent requiraments, 7'y was the"tat used oil rtlartaement stan- <br /> Thla notiReatlan Is for Information only, Lowry I <br /> y wry Driver Signature X 1•. <br /> Signature of Generator,Representative or Agent of Generator; X J .�' ,•,;• <br /> Batmnastd Tworw Yuma Invtranmentar. J <br /> 1829 E.Brundsgs LaneBokwwW 1716 F.13th <br /> 091-3224268 01107 Yuma,AZ 053as Mm <br /> #2x•341.4620 <br /> Recycling DeO °6 AatbbobIU24 Ad� <br /> &Dlapasal ��j # k <br /> Facilities Rl"rb(v'*all Tr newer 5266 orrrr,era., <br /> Claus Read Ramos Lovkrongrsrrtal <br /> R1WV bsek,CA 06867 s to $.toyer Raad <br /> 209463-8181 119.37 ,CA t168Dt hlwrpr <br /> C 1747 <br /> CAL000190816 AboADe6a00]6aa <br /> EPI 10: <br /> REV.4-17 <br />