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95360 GEORGE ��gSam Environmental Services Division WinVE RGEIN\C. 46129:P.Oexrt,S170,edld0.CA380 4812 K1.me Court,9a11da,CA BSIBB ® �� Consolidated Manifest Ph ons:209-545-0701 FAX209345.2241 9 L Invoice EPA9CAR000047919 \A P.TROLEUM PROBUCTa CBNPANY CA Tren.porWr Number 3844 CA Licsnee a 758518 IERATOR: Invoice N° 40000162 PA ID N: r.e' 6 of) 'Z'1; CjV Invoice Date: r^ 4 ct Parson: Driver Printed Signature: 40ZV,,t^— Truck PO If State,Zip: hone: Product Shipping Name West. CA Manifest Ro quantity Unit. Price Amount Code I-RCRA Hazardous Waste Liquid(Used.04):Lubricall 221 00 i-RCRA Hazardous Waste Llgaid(Used M:Industrial 221 en IRCRAHazardous Waste llquN(Used AulomogveAnti(reeze) 134 'G s' oat i-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gel i-RCRAHazardous Waste Sc#dsConleminatedWthUsed 00 352 p( Med Used Oh Filler Drum(s) - Drum(.) ply Drum(s) E..h nspodalion d Tnd 11me RR. dhemta.p.da.d an W.Comoedalod MaN/oel Reatpt(in vdw)T.,-:AccoonU due on Na tO�h of Netnodh fdlov.4,g nnnN of puchma.P.et duo Total (��2 %We,be domed o FINANCE CHARGE at the PERIODIC RATE of i-tl2%per month,wNU1la the ANNUAL PERCENTAGE RATE of 1814. J .7 lining I hereby certify that I have not mixed any of the waste described above with any other haou zards waste,the total halide content Is LESS Nan 1,000 ppm,end the e does not contain any PCB's.I have compiled with the requirements of the applicable Cattle mis used oil management regulation to determine this IS true.I agree to pt the addBMnal charges for the disposal of the waste,It the Information 1 have provided aboul this waste Is incorrect. '.. imfofs Cargfioagon:By Signing I Certify that If I am a large quantity generator,I CeNfy that I have program In piece to reduce the volume and toxicity of waste retell to the degree 1 have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal Currently able 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 nlze my waste generation and select the waste management method that Is available to me that I can afford. rile W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used 011 and Olty/Water may be transported to a facility that Is required to comply federal regulationsappl-bie to management of Used Oil and OIIylWater,but that Is not required to Comply with the more stdngenl lrequirements applicable to Woes waste management facilities.California facilities that handle or process Used Oil and 011yNlaler aro required to meet those more Stringent requirements,and e euld-state ladiities that process Used Oil and OIIy/Water also meet those requirements,engineering certifications of tank Integrity,and financlel assurances for ire and accidental releases,it Is lawful to send Used Oil and Oily/Water to out of state includes that comply only with federal Used Oil and OIly/Walor management dards and not these more shingent requirements. no08cation Is for the Informational pdrposes only. oN parties signing this Invoice It wig s.' an agreement that George W.Lowry,Inc.will submit Confirmation for(certain waste.beams)to the generator that their to has beantranspoded to a permitted tie a acidity orper ted treatment,storage or disposal facility. .owry Driver Signature X Data_ '.. itgnature'of Generator,Representative or goof of Generator:( Data Recycling,Transfer,Treatment,Storage,Disposal Faclll N.m.: E3 C3laid I JvPt.a& -H Addrna: sidTionsior California Oil Recyclin17g Ramos Environmental Yuma Environmental City,Stet.,Zip: E Brundage Lane 5300 Ciao.Road 1515 S,River Road 2730 E.13th .field,CA 03307 Riverbank,CA 86367 Wast Sacramento,CA 95691 Yuma,AZ,85385 Phone: 2241258 209463-8 jai 91641713747 928.344.9826 0028258 CAL0000190811) CAD004003656 AZR000515924 EPA ID: