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<br /> Y 1¢u'L-t�u`(s �' 'r a)n..) ,,c; n ksS,`b•, r �'� t� )t .i ...� Y' p
<br /> Environmental Services Division
<br /> �. �'� Wxulnq,P.O.Bos 176,Bolide.G 95359
<br /> �' E®R�6.rING 46(2 taam.n Caart.s FAX.9,lide,CA 6541
<br /> Emirenmanbt�ndc°so °^ Consolidated Manifest Phonv:209-5r507at FA><m9 -��t
<br /> P.O.9ex1T6,sa0da.rA9s= PPA 0 CAROe00 MS
<br /> s+5d°CA9s1sa rrrawraTa cex.ANT Invoice GTrarmporter Numbvr384a
<br /> /�►�r Manifest �' 79t FAtt1 GLlvarxa F75.518
<br /> ��®��70xiNG Consolidated M maple Qa47at9 fi "40100531 40000531
<br /> CATs xPoder"--35" pLm�,oice
<br /> Invoice GENERATOR ato: ()—,N° 40000583 She EPA ID fi GO(J D S iMadSigna
<br /> Invoice
<br /> contact Ptrsom t
<br /> 1 4-r-r GENRlmroice Data: '`—IO Name G.aS Address: IM0 C(, ar SHoEPAIDri: /L � Drtvar Pdnod Signature:Contact Person: Tnwks: \Zti City.State,Zip: inn
<br /> Name: P09 SRe Phone:
<br /> wmrta CA Manifest 00 Otrantlty uMts price Amount
<br /> a1,6vL
<br /> Address: C `. Product Shipping Name code
<br /> T MS• S D
<br /> City,state.Zip, �--' /26�� << zoo
<br /> tkde Pdce Amount Nat-RCRA Haardou9 Waste UGuid(Used 00'.Lubricbtlng � 0 1 t7 {
<br /> Quantity c>t
<br /> Silo Phorte: CA Memld#O =i
<br /> wan. NoIrRCRA Haardous Waste liquid(Used Off:Induslrai ZZt
<br /> Product Shipping tame ted` ��tt GW
<br /> 221 o q 6 G << Z Non RCRA Haatdous Waste LiW d(Used Autombt a ANamea) 134
<br /> Waste Liquid(Used 08):Lubtiating wl �. G't
<br /> Nor-RCRA Hazardous ," Non.RCRA Ftaardau Waste Liquid(011&Water) 223
<br /> Industrial Gd them(.)
<br /> Non.RCRA Hazardous Waste Liquid(Used Off: s
<br /> (Used
<br /> Non RCRA Hazardous Waste Uquei --Antifreeze) 134G.i Nal-RCRA Haa(dous Waste Solids CorRammated with Used Oil 312 D—m(a)
<br /> 223 Doo(x) CS Drained Used IN Flier Dmm(s)
<br /> ud Ort 8 Wafer) �G r�
<br /> NarRCRA Hazardous Waste L'q ( Errpty Drums)
<br /> rdous Waste Sdids CotdammaledwM Used 00 352 �� weirla) RR.
<br /> Non-RCRA Hata Transportation&Truck Time ..
<br /> Drained Used Oil Fitter Drum(l) -
<br /> RR
<br /> Empty Dmm(s)
<br /> Trdnspodation&TtucI(Time
<br /> Past due Total sf7 ;
<br /> lhdea oaxrvdva spotl6ad FItldscw,5oedakx!Mmdfaat Remipt Prwam)T-ir A°me,uhd �Ew�tlahANNWLPERCENTAGE RATE of iWSo. (/
<br /> arramn yqi pv W19 y a FlNANCE CHMGEat aw PPRIODIC RATE W 7-iQY.parrr�on
<br /> Tobi �2 B I hemb oatlfy that I have not mixed any of the—n descebed above vAth any other harudous waste,the total haide content d LESS then 1,000 o.I and the
<br /> deo m ew tan a 9x mootn iW odrre^o^tl'W °Pau eue Y signing Y t tl o determine this E no.t a9neo 0
<br /> Imdea)Tanx:AcmeNa AGE RATE d telt. w ste does nor ccntain any PCB's.1 have compiled with the requirertrents of the appliable Caidoma used of maragoman regWa'on
<br /> I uroosa othoratsa spod0ad w We Coreadeed�0 P pA7E o(t-tRX Por mo"N.' �w the ANNOA�PERCENT and the accept No addition charges for the disposal of the waste H the Information 1 have Provided about Ous waste a incorect.
<br /> 1 aayaon w5l ba Wn9ada FmANCE Ct1AR nt Ln LESS than 1.000 PPT^. .
<br /> descdbed above vAlh arty.Har hezadous weals'the foal ha0de atwn o detnminw this is true.I agree to Genaalors Cer ifirvtlon:BY signing 1 cerafy that If i am a large quantify generator,i cenfify Hat I have program in Place to reduce the volume and todcry.1 was
<br /> l of Hne wast° ble Calaomb used of management regtd generale A to the degree I have dotertNmad o nd awnoMWly affordable and that 1 have selected Ha Pra small q method n treatment amastorage,a disposal currently
<br /> BY si9nin91 hereby certify that I have not mooed arty s, is of the appflca available o me which minim—the Present and tueue 81st.1 human fife and Ho environment Or,it i am a small quantity 9ororaor,1 have made a Good Faith e8ort to
<br /> Tied with Hre raga) tion I have provided about this waste h Incorrect. volume and toxicity of wast° rte tion and soled iha waste management method that's available to me that 1 can.Rod.
<br /> waste does rot contain any PCB's.1 have co of wash Rthe i nforma n place to mdua:the minimize my vra ganam
<br /> aax:pl Ure additional o comply
<br /> charges for the dispose rotor,I wrt,y gnat 1 pprogram storage,w dePoaal.wrtendY rators shiPrnant of Used Ol and alylWater may be transported to..duty that is required 6oblond
<br /> I GenO(y Ifhat R I am a ting.gonn8ty Band that t hrtvo seled.d racHcable method of treabnant GWlge W.Lovay,Inc hereby advtsas the above Generator Hat gene o comply with the mom sbin0ent requhaments app a and
<br /> to
<br /> L Or,a t am a arra'.=ty generaor,I have made a Good FaOh°flat to OflyfWaw am _ meet
<br /> G.nerators CeNficatlon:Bnasgr�-�to be ecanen9caay afford haz federal asto mens.mensfapplicable b management of Used Oil and OIYNvanr.but that is andnot __
<br /> gaaralod b the degree ar� present and future threat o human Nfe and the l oVe tmnon�I can.Rad. b that b r� o,�,,,qy hazardous wase management fproces-California fcahle.that Used 0 and Oly/Yvateraa4so°meett those requi aramants,angineenn9—ply
<br /> onla0ore a tank integrity.dOil and rmanaal assuranas for
<br /> available o ma which miminiza select Ha waste managemoNmemod Gat Is avellabie mad t°a tea tY mmaNs-aPPaaaNO to same Duro(-sba fadlMes that Proaeas
<br /> mlNmize my waste genefa9on shipment of Used ql and Oayl Wator may b re 6�9e rt .requirements-and closure and accidental releases,h is awU b send Used Oil and OIyN✓ator to out of state faWtdes Hat camPiY only wire federal Used Oil and OIIylYvaler managaman
<br /> Generator
<br /> that generators frac o comply standards and not these mom stringent mquHe"n"'
<br /> GWrge W.(.awry Inionhereby advises Me above s applicable to management
<br /> of Used 01 and abfWaar. �marc Day not are ra7uirad b meet those mor. dei assurances for
<br /> with federal
<br /> edea wash management fadldes Callfamto(acides that handle or Pro°eas maty-Mireadng caHfi-111-of ark Used
<br /> OR and 1yyaar managomont This noHHcation is for the INommtional W only.
<br /> Used OH and OOYfWa<ar also rtoet those nequtra on whit fedaai Used Ol and OIy this Invoice as an agreement that George W.Lowry.Inc.wID submit ility. .tion for(curtain waste streams)o Hhe geromor that noir
<br /> haz
<br /> some oa-oi-sno fac9laes that process Used Oil and OIIyN✓aler'to Wt of stat.fadiMes shat comply h waste
<br /> both parties signup er facility or Permitted treatment.storage or disposal facility.
<br /> dosum and accidental releases.R is awful to send wase hos been transported o a
<br /> these more stringent roGn'm^re^is' Date U^ )!J
<br /> sondardsaed�( ms sea generator that Moir Lowry Driver Signature
<br /> i for Ha iNom'ationaf Purposes arty' owry fimatlon for(carni^wase s1rPa ) Date
<br /> This ro0fication s ont at Goago W' star...o d suamftadW
<br /> nvoice Hw@ as Ittad eeamhenL storage or disposal Signature of Generator,Rep ntative or Agent of Generator. X
<br /> ey boa Pates signing this I--!-
<br /> By
<br /> o a pert dD
<br /> waste has been transported Data
<br /> Date
<br /> Lowry Driver Signature X
<br /> • ntative or Agent of Generator. X Recycling,Transfer,Treatment,Storage,Disposal Facilities t tes N
<br /> Signature
<br /> ___-------
<br /> Signature of Generator,Rep ❑ ® --
<br /> U City,5ety LP:
<br /> _ Norma: d 7rarrsiw
<br /> California O\Recycling Ramos Emironmonni Yuma Environmonbi
<br /> ge,Disposal Facilities 1620 E Brundage Lana 5300 Claus Road 1515 S.Ritrer Read 2730E 13th
<br /> Recycling Transfer,Treatment Addrssa: Mansfield.CA 93307 Riverbank,CA 96W West Sacramento,CA 95691 Yuma,AZ,85365 --
<br /> 6613228258 2098638181 916371.6747 928344-9826 EPAD:
<br /> ❑ City.seta.9p: rA1D00019061r/ CAD004003556 AZR000515924
<br /> ® r1�-ray Yuma Envtronm..tai CAL0002825H
<br /> CaTrtom�ia 011 Rerydin9 Rahexs Endmnmo n 2730 E 13th Phere:
<br /> Bak—, Tmnster 1515 s.River Read
<br /> 1620 E Bmnda90 l.ano 5300 Claus Ro pleat yaameno,CA 95691 928-344-9826365 EPA o: —
<br /> Yuma,A7
<br /> BakenBold,CA 93307 Mvcrba"14 CA 97G 471.947 A7R000515924
<br /> 661.3228250 CAL000019007V
<br /> CAL00026258
<br />
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