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Environmental Sorviws Division G M,01ng.P.O.13-176.Salida,CA 95360 '"G Consolidated Manifest 4512RIomanCourt,Solid,,CA96353 Phan.:209.505-0791 FAX209-3452241 QIAA�rn PnoouGTe aoMPgNV Invoice EPA A CAR000047019 CA T.naportsr Number 3844 CA Lic.ns.i 750518 NERATOR: Invoice N° 40000162 EPA 10 e: 0 UC) •Z7 4; dF� Invoice Dale: A-?i fact Person: Driver Printed Signature: G1AA W L Truck N: Z, foss: V�'� PO g State,Zip: S Phone: ET Rh1S. Product Shipping Name cods CA Manifest RO quantity Unita Price Amount x-RCRA Hazardous Waste liquid(Used GIN:Luting 221 v 0 (,.� 2;j f7 Gal ';S- SZ •,5'a 9o-RCRA Hazardous Waste Liquid(UW Oil):Industrial 221 Gal (J an RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 () .' — on•RCRA Hazardous Waste Cpud(OH R Water) 223 Gal m-RCRA Hazardous Waste Solids Contaminated vdth Used Oil 352 p(a LL, l o--(.f w 3 ` raved Used 011 Filler Onun(s) omm(.) Tply Dfum(S) 6✓4.,! Each 'anspOfL3Hon$Truck Time HR. to dt—ft*specAld on Onto Consoadatod Manfo t R—Ipt(Irvin.)Tome:Accounts at.on ea IM of the nnnlh fail-ing month of purchase.Pool duo -let {` 2 tris lbs rhagae.FINANCE CHARGEat the PERIODIC RATE of 1-lf^par morin,Itdch is NO ANNUAL PERCENTAGE RATE of 18%. Jct J• ':. Ilgning I hereby certify that I have not tNxed any of the waste described above with any other hazardous waste,the total halide content Is LESS than 1,000 ppm,and the to does net contain any PCB's.1 have,complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree to ' apt the additional charges for the disposal of the waste if the information I have provided about this waste la Incorrect. ..fors Certification:By signing I caNy that It I em a large quantity generator,I corny that I have program in place to reduce the volume and toxicity of waste emted to the degree I have determined to be economically affordable and that I have selected the practicable method of treatment,storage,or disposal currently table to me which minimizes the present and future threat to human His and the environment.Or,H I am a small quantity generator,I have made a Good Faith effort to 'Mr.my waste generation and select the waste management method that Is ava0abie to me that I can afford. ago W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used OH and Oily/Water may be transported to a Notify that is required 1.Comply i federal regulations applicable to management or Used Oil and OIIyMater,bud that Is not required to Comply will the more stringent requirements applicable to '.. Mous wasto management facilities.California facilities that handle or process Used Oil and OIIy/Water era required to meet those more stringent requirements,and is outof•st bite fadiitles that process Used Oil and Oily/Water also meal those requirements,engineering certifications of tank Integrity,and financial assurances for ure and accidental releases,it Is lawful to send Used 04 and OOy7Waler to out of slate faclHHas that Comply only with federal Used Off and Oily'Water management dards and not these mom stringent requlremonis. r notification Is for the Informational purposes only. xxR parties signing this invoice it colli sery a an egraement Net George W.Lowry,Inc.oil submit Confirmation for(wrtain waste streams)to the generator that their to has been transported to a permitted b, a acflity or per lied treatment,storage or disposal facility. .owryDriver Signatt - Date itgnature'of Generator,Representative or Agent of Generator: Date -13`d Recycling,Transfer,Treatment,Storage,Disposal Faclll [3 p Address: old Transfer California 011 Recycling Ramos Environmental Yuma Environmental City,slate,z)p. E Bnundag.Lan.5700 Claus Read 1515 S.River Road 2730 E.13th 9fldd,CA93307 RI...bank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 Phan.: ,241258 209863-8181 916.3713747 926-344-9826 )028250 CAL000019081,t CAD004003556 AZR000515924 EPA w: