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Environmental Services Division Melling:P.O.a..ITS,S.IId.,CA 05368 4612 RI.—Court,$slid.,CA 05365 '"� Consolidated Manifest Phona:Ree546-0701 FAXR0934S2341 •`- Invoice EPANCAp.rl"H b(rEORGE m eGN PBe,DVOTa CONIANY CA Tnn.port.r Number3644 CA License N 768515 GENERATOR•. — Invoice No- 40000098 Sita EPA ID N: invoice,Data: - 3- Driver Printed Signature: 4 . Contact Person: Name: Truck N: Address: PON city,state,Zip: TERM$t Sha Phone: Product Shipping Name W . CA Manifest NO Quantity Unll. Price Amount Cod. �/ Non-RCRA Hazardous Waste Liquid(Used 011):Lubrtcatlng 221 -t lC Gal 3S' 1 Non-RCRA Hazardous Waste Liquid(Used OIQ:Industrial 221 Gal ry 0.1Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 V Non•RCRA Hazardous Waste Liquid(Oil 6 Water) 223 Gat a Drvm(s) z Non-RCRA Hazardous Waste Solids Conleminafed with Used 011. 352 Uz l -1 L f J,J l 1 cJ Drum(s) Inad Used OU Ftltec Drum(s) '.. Each Empty Drum(s) Hft. Transportation 5 Truck Time sceoon WA be chuod a FIRMCE CHARGE at No PERIODIC RA TE of m2%per month.which is Uw ANNUAL PERCENTAGE RATE of lis%.affi of Post due Toto 76 P-r By signing i hereby sanity that I have not mined any of the waste desc4ibed above with any other hazardous waste,the total halide content Is LESS than 1,000 ppm,and the , waste does not contain any PCB's.I have compiled with the requirements of the apptkabie California used oil management regulation to detem ire this Is true.I agree to accept the additional charges for the disposal of tho waste If the information I have provided about this waste In Incorrect. Gonemlofs Certification:By signing I Car*that If I am a large quantity generator.I codify that I have program In plow to reduce the volume and toidclty of waste generated to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,w disposal amenity available to me which minimizes the present and future threat 10 human life and the environment or,U 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 OU and OIIy/Wa ar may be transported to a facility that Is required to comply with federal regulations applicable to mahegament of Used Oil and 011yfWater,but that Is not required to comply with the more stringent requirements applicable to hazardous waste management facilities.California facillUea that handle or process Used Oil anti OUyWater are required to meet those more stringent requirements,end some ouW-state fecgNes that process Used Oil and OUyANeler also meet those requirements,engineering certifications of tank Integrity•end financial assurances for closure and accidental raleases,It Is lawful to send Used Oil and OIIylWaler to out of State facilities that comply only Will federal Used Oil and 011yMlater management standard.and not these mora SMngent regWrementa, ' This notification Is for the informational purposes only. By both peltas signing this Invoke it will Serve as an agreement that George W.Lowry.Inc.will submit confirmation for(certain waste streams)to the generator that their wastehasbeenbanspodedtoopermitted��st�r ciiityorpermittedtreatment,stomgear dlspoael facility. Lowry Driver Signature XC4g Date Slgnature'of Generator,Representative or Agent of Generator: X 'TA -� Date Recycling,Transfer,Treatment,Storage,Disposal Facilltles N.— O ❑ ❑ ❑ Addr.se: Bokoreffad Transfer California 011 Recycling Ramos Environmental Yuma Environmental City,Sten,23p4 l 1820 E.Brundage Lane 5300 Claus Road 1616 S.River Road 2730 E.13th ph..: Bakenlold,CA03307 Rtvorbank,CA96367 West Sacramento,CA 05601 Yuma,AZ,05365 661.322.8268 209.1163.8181 915-37137478284 .8826 EPA 10: CAL00028258 CAL0000180817 CAD004003655 44 AZR000515924 i