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1 <br /> Envlronmental Services Division <br /> N ems} Q } Mailing:P.O.Box 076,Salida,CA 85380 <br /> INC. Consolidated; Man'fest Phone:4612 12095450791SaFAX 09545lllda,CA 82241 <br /> WILOWRY <br /> EPA#CAR000647019 <br /> ,CGEORGE <br /> PETROLEUM PRODUCTS COMPANY � ; <br /> Invoice <br /> ce CA Transporter Number 3844' <br /> ! CA License#758518 <br /> GENERATOR: Invoice <br /> N_ <br /> Site EPA ID#: jr - - invoice Date: f <br /> Contact Person: Driver Printed Signature ' <br /> Name Truck#: s <br /> Address: u, PO# <br /> ' 1 <br /> City,State,Zip: <br /> Site Phone: TERMS: <br /> Product Shipping Name Waste CA Manifest#0. <br /> Code; Quantity Unita , price Amount <br /> a C <br /> Non-RCRA Hazardous Waste Liquid(Used.011):Lubricating 221 ,r G ' <br /> Non-RCRA Hazardous Waste Liquid(Used 011): Industrial 221 cat 1 <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134Gal; i <br /> Non-RCRA Hazardous Waste liquid(011&Water) 223 Gal <br /> 1 <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used 011 352 Drum(e) <br /> 1 <br /> Drained Used Oil Filter Drum(s) Drum(s)' <br /> Empty Drum(s) 1 Each <br /> Transportation&Truck Time 1 HR,t t <br /> 1 <br /> t <br /> Y <br /> 1 <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of the month foilowing month of purchase. Past clue i f Total <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%per month,which Is the ANNUAL PERCENTAGE RATE of 18%. <br /> By signing I hereby certify that I have not mixed any of the waste described above with any other hazardous waste,Jill total halide content is LESS than 1,000 ppm,and the <br /> waste does not contain any PCB's.I have compiled with the requirements of the applicable California used oil management regulation to determine this is true.I agree to <br /> accept the additional charges for the disposal of the waste if the information I 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 volu a 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, ordisposal currently <br /> available 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 can afford, I <br /> l <br /> George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and 011y/Water may be transported to a facility#hat is required to comply <br /> with federal regulations applicable to management of Used 011 and OIIy/Water, but that is not'required to comply with the more stringent requirements applicable to <br /> hazardous waste management facilities.California facilities that handle or process Used Oil and OIIy/Water are required to meet those more'str�hgent requirements,and <br /> some out-of-state facilities that process Used Oil and jOily/Water also meet those requirements, ely only ngineering certiflcations',of tank integrity,a dj;finahcial assurances for <br /> closure and accidental releases,it is lawful to send Used Oil and Oily/Water to out of state facilities that coma with federal Used OII andi'OIIyNVater management <br /> standards and not these more stringent requirements. <br /> This notification is for the Informational purposes only. <br /> 1 <br /> By both partles signing this invoice it will serve as an agreement that George W.Lowry,Inc. will submit confirmation for(certain waste streams)to the generator that their <br /> wastehas been transported to a permitted trapsfer4acllity or permitted treatment,storage or disposalFfacility ! ! <br /> Lowry Driver Signature XDate <br /> Signature of Generator,Representative or Agent of Generator: X Dae 61 1` <br /> Recycling,Transfer,Treatment,Storage, Disposal Facilities Name: <br /> 13 <br /> 13 ® ® Address: <br /> Bakersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental city,State,Zip: ' <br /> 1620 E.:Brundage fLane 5300 Claus Road 1515 S.River Road 2730 E.13th <br /> Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 Phone: <br /> 661.322-8258 209.863.8181 916.371.5747 928.344-9826 <br /> CAL00028258 CAL0000190817 CAD004003556AZR000515924 EPA ID: <br />