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Environmental Services Division Mailing:P.O.Bou 176,Salida.CA 95388 INC.GEORG pg g� . 4812 Woman Court,$slide,CA 05366 Consolidated Manifest Phone:209.545-0781 FAX 209.945.2241 ALOWRYp Invoice BPA 0 CARD00047019 A PaTROLaeM Prp IAMNY ® �I CA Transporter Number 3844 CA License M 7588111 NERATOR, inV— N2 40000442 Situ EPA ID d: OCR) Invoice Contact Person: Driver Printed signature: SA A -CS Name; C p Truck Address: 1 PO# City,State,zip: �( site Phone: ER Product Shipping Name Waste CA Manifest#0 Quantity Unite Price Amount Code Nan-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221 Gel Non•RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 eat Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drums) Drained Used Oil Filter Drum(s) Drum(s) Empty Drum(s) Each Transportation&Truck Time HR. Unless otherwise spediied on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the month roti owing month of purchase. Past due Total accounts wW be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%per month,which is the ANNUAL PERCENTAGE RATE of 18% , 19y 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 then 1,000 ppm,and the waste does not contain any PCB's,I have compiled with the requirements of the applicable California used oil management regulation to determine this is true.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 Certlncaliow.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 avallable to me which minimizes the present and future threat to human life 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 required 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 most those more stringent requirements,and some out-of-state facilities that process Used Oil and OIIy/Water also meet those requirements,engineering certifications of lank integrity,and financial 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 Oily/Water management standards and not these more stringent requirements. This notlOcatlon Is for the informational Wposesornly By both parties signing this invoice It wiGeorge W.Lowry,Inc. will submit confirmation for(Carlson waste streams)to the generator that their waste has been transported to a permitd treatment,storage or disposalfacility. Lowry Driver Signature M —,_.. Oats-3 — •®~t Signature of Generator,Representative or Agent of Generator: X Da to Recycling,Transfer,Treatment, Storage,Disposal Faculties �Name: 1I Addraes: 1 13 13 ®ersffald Transfer alifomis Oil Recycling Ramos Environmental Yuma Environmental City,slate,zip: 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th Bakereneld,CA 93307 Riverbank,CA 983x7 West Sacramento,CA 05691 Yuma,AZ,65355 Phon®' i 661-382.8258 209.863-5181 918371.5747 828.344.9828 EPA 10: CAL00028258 CAL00001sitili y CAD004003556 AZR000515924