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Environmental Services Division " Mailing;P,O.Box 170,Salida,CA 95388 GEINC. Consolidate Manifest4812KIemanCourt,Salida,CA95368 Phone:209.5450791 FAX 2085452241 WLOWRY Invoice EPA N CAR000047019 A PETROLEUM PRODUCT*COMPANY CA Transporter Number 3844 CA License 0 759518 ,_ERATOR: Invoice N2 40000598 Site EPA IB 0: / u 0 5S Invoice Date: t ` Contact Person: Driver Printed Signature: G Name; ` �/• Truck#: '— Address: i•'C0 vA_cSt PO# City,State,Zips e-c' a/ vi li Wto Phone: SMS: Product Shipping Name Waste CA Manifest#0 Quantity units Price Amount Code Non-RCRA Hazardous Waste liquid,Used O-R;:Lubricating 221 Gal Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 ( W4 ikL -5 Drum(s) Q l vN Dra ned Used 07 Filter Drum(s) DrurniQ Z¢✓S� Empty Drum(s) each Transportation&Truck Time HR. Unless oiharMse specified on this Consolidated Manifest Receipt(Invoice)Terms: Accounts due till the 100:of the month following month of purchase. Past due Total accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-112%per month,which is the ANNUAL PERCENTAGE RATE of 18%. � r By signing I hereby certify that I have not mixed any of the waste described above 0h 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 complied with the requirements of the applicable California used oil management regulation to determine this is tare.I agree to accept the additional charges for the disposal of the waste if the Information I have provided about this waste Is incorrect. Generator's Certification: By signing I certify that If 4 am a largo quantdy generator, t 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 dffsposal currently available to me which minimizes the present and future threat to human We and the environment.Or,If I am a small quantity generator,I have made a Good Faith effort to minimize my waste generation and select the waste management method that Is available to me that I can afford. George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and Oily/Water may be transported to a facility that Is requ"red to comply 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 hazardous waste management facilities.California facilities that handle or process Used Oil and Oily/Water are required to meet those more stringent requirements,and some out-of-state facilities that process Used Oaf and Qity/Water also meet those requirements, engineering certifications of tank Integrity,and nnancle(;Assurances for closure and accidental releases,it is lawful to send Used Oil and Oily/Water to out of state facilities that comply only with federal Used Oil and OilyWiter management standards and not these more stringent requirements. This notification is for the informational p%A ose 0 By both parties signing We Invoice i III e s greement that George W.Lowry.Inc, will submit confirmation for(certain waste streams)to the generator that their waste has been transported to a par d rtt 1e f cility or pe' lttii treatment,storage or disposal friellity. Lowry Driver Signature X.., Date Signature of Generator,Re resen ative or Agent of Generator X_ Recycling,Transfer,Treatment,Storage, Disposal Facilities Noma: Address: Bakersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental City,State,Zip: 1820 E,Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th ' Bakersfield,CA 93307 Riverbank,CA 95357 West Sacramento,CA 95601 Yuma,AZ,85365 Phone 881-322.8258 209.863.11181 g18371.5747 928.344-9826 EPA to: CAL0002825�j CAL000019081� CAD004003556 AZR000515924