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Environmental Services Division flailing:P.O.Box 176,Salida,CA 95360 4612 Kiernan Court,Sallda,CA 95368 Consolidated rifest Phone:209.545.0791 FAX 209445.2241 A PaTROLOUM PRODUCTS COMPANY Invoice EPA 0 CAR000047019 CA Transporter Number 3044 CA License d 758518 ENERATOR: (nvolce N° 40 ® o Q 5 9 site EPA tD a; Invoice Date: Contact Person: Driver Printed Signature; �I '� Warne. , �r Truck M Address: PO a City,State,Zip: L tiy1 Slto Phone: TERMS: Product Shipping Name Waste CA Manifest#0 Quantity links Code Y Price Amount Non•RCRA Hazardous Waste Liquid;Used 0%:Lubricating 221 cal Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 Gaal IN70,1RCRA Hazardous Waste Uquid(Used Automotive Antifreeze) 134 oat Non•RCRA Hazardous Waste Liquid(Oil&Water; 223 Gal Non•RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(s) f3 1 Dra ned Used Oil Filter Drum(s) E Drums) 'i t Empty Num(s) Z5 5. Each Transportation b Truck Tme HR Unless oihorwise specified on this Consolidated Manifest Receipt(Invoice)Terns: Accounts cilia on the 100r or the month follovnng month of purchase Pastdue accounts will be charged a FINANCE CHARGE at the PERIODIC RATE or 1-1r2%per month,which is the ANNUAL PERCENTAGE RATE of 18%. Total 1 C ' A � By signing I hereby certify that I have not mixed any of the waste described above QIA 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 complied 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 Certification:By signing I certify that If a am a targe quantty generator, f 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 dsposai currently available tome 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. Goo es the above r that withrfederal Lreg regulations applicablelsto management of UsedOilOilg ndrators Oily/Waterent r. butthatsed Is ort and requiirred to comply with be the more stringent requiremethat is nts s rappl applicable 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 Oa and OilyMater also meet those requirements, engineering certifications of tank Integrity,and Enanciatassurances for closure and accidental releases,it is lawful to send Used Oil and OilyrWater to out of state facilities that comply only with federal Used Oil and OdyWater management standards and not these more stringent requirements. This notification is for the informational pa ose ori By both parties signing th s invoice 1 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 per 'tt d ra slat f cility or per ii treatment,storage or disposal facility. Lovvry Driver Signature X a Signature of Generator,Re resen ative or Agent of Generator: X °:, recycling,`transfer,'treatment, Storage, Disposal Facilities Nome: " ,"0,{� _ J♦ 6�vY"T tv (Addrasa: easersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental City,State,zip: 1620 E,Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th -- Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 (Phone: e81.322.0258 209.863.8181 916371.5747 928.344-9826 CAL00020251 CAL000019001 CA000400355eAXR000515924 EPA ID: