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" . Environmental Services Division
<br /> Mailing:P.O.Bou 176,Salida,CA 95360
<br /> tNC. Consolidated
<br /> ��� � 4612 Kiernan Court,Salida,CA 95368
<br /> � WMLOWRY Manifest Phone:200.545-0791 FAX 209.545-2241
<br /> ,APBYR068UMPRODUCTS COrAPADdV Invoice
<br /> EPA 0 CAR000047019
<br /> CA Transporter Numbor 3844
<br /> CA License 0 75961$
<br /> GENERATOR, onyoiee NQ 400004 � 2 m
<br /> Sit€)EPA ID M �t jd' — -- - —
<br /> _ invoice Date: P U�t
<br /> Contact Person. Driver Printed Signature: -
<br /> Namo; It, r Tructc
<br /> Address; IkAL14 POP
<br /> City,State,Zip: ry A -
<br /> Slto Phone; TERMS-
<br /> Product
<br /> ER :
<br /> Product Shipping flame WastCode CA Manifest ff0 Quantity Units Price Amount
<br /> Cod®
<br /> Nan RCRA Hazardous Waste Liquid(Used Oil):Lubricating 229 oat
<br /> Non-RCRA Hazardous Waste Liquid(Used Oil); Industrial 221 Gal
<br /> Non RCRA Hazardous Waste Liquid{Used Automotive Antifreeze) 134 _ cal
<br /> Non-RCRA Hazardous Waste Liquid(011&Water) 223 cal
<br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 pn,m(a)
<br /> Drained Used Oil Filter Drum(s) Drum(e)
<br /> Empty Drum(s) Each
<br /> Transportation&Truck Time HR.
<br /> Unless otherwise specified on this Conaolidaled Manifest Receipt(Invoice)Terms: ,, unto due on the 10th of the month following:month of purchase Past duo Tota=ZZ:-5-0
<br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of t-7!296 per month,which is the ANNUAL PERCENTAGE RATE of 18%
<br /> Ey 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 than 1,000 ppm,and the
<br /> 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.1 agree to
<br /> accept the additional charges for the disposal of the waste if the Information 1 have provided about this waste Is incorrect
<br /> Generator's Certification: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
<br /> generated to the degree i have determined to be economically affordable and that I have selected the practicable method of treatment, storage, or dispose,currently
<br /> 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
<br /> minimize my waste generation and select the waste management method that is available to me that I car)afford.
<br /> 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
<br /> with federal regulations applicable to management of Used Oil and Oily/Water, but that Is not required to comply with the more stringent requirements app'icable to
<br /> ttazardous waste management facilities.California facilities that handle or process Used Oil and Oily/Water are required to meet those more stringent requirements,and
<br /> some out-of--state facilities that process Used Oil and Oily/Water also meet those requirements, engineering certifications of tank integrity,and financial assurances for
<br /> closure and accidental releases, it is lawful to send Used Oil and OilyfWater to out of state facilities that comply only with federal Used Oil and Oily/Water management
<br /> standards and not these more stringent requirements.
<br /> This notification Is for the Informational p• poses only
<br /> By both parties signing this invoice It will rNre+ a - e, ant G George W.Lowry,Inc, will submit confirmation for(certain waste streams)to the generator that their
<br /> waste has been transported to a permit trip or fa 'ty or p ;ittad treatment,storage or disposal facility.
<br /> Louvey Driver Signature ,. Date-h—d___t
<br /> Signature of Generator,Representative or Agent of Generator; X�_, a �,
<br /> Date ""Z
<br /> (Recycling,Transfer,Treatment, Storage,Disposal Fatalities Name:
<br /> ` _
<br /> il 13 13
<br /> Sattrrs8oid Transfer alifomia Oil Recycling Ramos Environmental Yuma Environmental City,state,zip:
<br /> 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.131h
<br /> Salioraffeid,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 Phone:
<br /> 661.322.0258 209.863.8181 91WTI-5747 928.344.9826
<br /> CAL00828258 CAL000019011II& CAD004003S86 AZR00051S924 I EPA ID:
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