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,y <br /> Environmental Services Division <br /> ' Malllrlg:P O Box 0�(6,Salida,CA 95368 <br /> ■ y 4612 kleman Coutt�a11d8,CA 98368 <br /> Wia Consolidated Manifest Phone:209545{0t(FAX2095t5.2241 <br /> EPA#CAR000047019 ? j <br /> qGEORGEINC. <br /> WNRY <br /> OLEUM PRODUCTS COMPANY 1 n9/o Ce <br /> YY CA Transporter N�Mber 3844. <br /> `CA License#7585181 <br /> GENERATOR- Invoiceo ` <br /> Site EPA ID#: <br /> Invoice Date:' _ I. <br /> Contact Person Driver Printed Signature <br /> Name: <br /> Truck'#: <br /> Address: t PO <br /> City,State,Zip: ' <br /> i <br /> Site Phone: TERMS: <br /> i <br /> Product Shipping Name waste CA Manifest#0Quantity? Unit Qr�ce Amount <br /> Code <br /> Non-RCRA Hazardous Waste Liquid(Used 011):Lubricating 221 t Gall 1 <br /> Non-RCRA Hazardous Waste Liquid(Used 011): Industrial 221 <br /> Gal' <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze)', 134 calf <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 + (3ai, to <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(5), <br /> Drained Used Oil Filter Drum(s) 1 t Drums>' <br /> , <br /> Empty Drum(s) Each j <br /> , l , <br /> Transportation&Truck Time HR,i <br /> , <br /> 1 ' <br /> r i <br /> i <br /> t 7 <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms;Accounts due on the 10th of'the'monlh following month of purchase. Past due (plat <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%t r <br /> By 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 LESSthan 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 detennIne 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 i <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 volumeanal=toxic ty of waste <br /> generated to the degree I have determined to be economically affordable and that 1 have selected the practicable method of treatment,storage,ora disptl 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 tome that I can afford; <br /> George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and OIIy/Water may be transported t0 a facial y that is required to comply <br /> with federal regulations applicable to management of:Used Oil and Oily/Water, but that Is not required to oomplywith the more'stringent1requlrements applicable to <br /> hazardous 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 011y/Water also meet those requirements,engineering certifications of tank integrity, d,ifirlanciai assurances for <br /> closure and accidental releases,it is lawful to send Used Oil and Oily/Water to out of state facilities that comply;only with federal Used Oil andj Opy/Water management <br /> standards and not these more stringent requirements. <br /> � i <br /> This notification Is for the informational purposes only. <br /> By both parties signing this invoice it will serve as an agreement that George W.Lowry,Inc, will submit confirmation for(certain waste'streams)to the generatorthattheir <br /> waste has been..transported to a permitted transfer facllilyor permitted treatment,storage or disposal facility. <br /> Lowry Driver Signature X r Date j <br /> 1 <br /> Signature'of Generator,Representative or Agent of Generator: X Da <br /> I � I i <br /> b <br /> Recycling,Transfer,Treatment,Storage,Disposal Facilities Name: <br /> L � I <br /> a� n =t 13 13 13 <br /> Adareas: <br /> Bakersfield Transfer California Off Recycling Ramos Environmental Yuma Environmental city;state zip: <br /> 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th <br /> Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95891 Yuma,AZ,85385 Phone: ' <br />[ 661.322.8258 209.863.8181 916.371.5747 928.344-9826 <br />[ CAL00028258 CAL0000190817 CAD004003556 AZR000575924 EPA ID: <br />! <br /> , <br /> E w <br />