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<br /> Environment i I kS vice's Division
<br /> 1 Mailing:P.O.Box i�6,Salida,C 19536
<br /> INC. ■ } • 4612 Klsman Cour,3a0de,CA 9$388
<br /> Consolidated Manifest t Phon6:,20954510701=FAX209.545.2241
<br /> Invoice, EPA#CAR0000147Q19 i
<br /> qE70ROE M PRODUCTS COMPANY !
<br /> CATraosporterNOrnti r3pi
<br /> 44'
<br /> CA License#75I185all
<br /> GENERATOR: Invoice ° 1
<br /> Site EPA ID#: f ,° a�u, Invoice Date:
<br /> Contact Person: Driver Printed Signatur e �
<br /> Name ;' + th Truck
<br /> t �
<br /> Address: t r s, PO# r j
<br /> City,State,Zip;
<br /> Site Phone: TERMS:
<br /> Product Shipping Name code CA Manifest#0 Quantity 1'' Units I I Price Amount
<br /> Non-RCRA Hazardous Waste Liquid(Used,011):Lubricating 221 ; �'t ' ! Gal' 1 i
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<br /> i ; A `
<br /> Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 q Gal;
<br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 i _ Gall
<br /> .,
<br /> Non-RCRA Hazardous Waste Liquid(011&Water) 223
<br /> Gal!
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<br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drumts>
<br /> Drained Used Oil Filter Drum(s) Drums) I
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<br /> Empty Drum(s)
<br /> Each '
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<br /> Transportation&Truck Time HR.
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<br /> Unless otherwise specl0ed on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 101h of the month following month of purchase.113astclue !Total i
<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%. ; I i
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<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 LESS than 1,000 Rpm,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 determi e thiels 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. ;, s
<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 economicallyaffordable and that I have selected the practicable method of treatment, storage#, or disposal 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
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<br /> George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used'Oil and 011y/Water maybe transportedito a facility{h�t is r@quired to comply ;
<br /> with federal regulations applicable to management of Used Oil and Oily/Water, but that is not required to complyi with the'more istringenti rogtiireh}ants applicable to
<br /> hazardous waste management facilities.California facilities that,handle or process Used Oil and Oily/Water are required to meet those more Str'ingentire quiramants,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 asslurances 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 and'011y/ 'ater management
<br /> standards and not these more stringent requirements.
<br /> This notification is for the Informational purposes only.
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<br /> By both parties signing this invoice it will serve as an agreement that George W.Lowry,Inc, will submit confirmation for(certain waste, to tile generators that their
<br /> waste has been to a permitted transfer„facility or permitted treatment,storage or disposal facility i i
<br /> Lowry Driver Signature X ' � '� Date
<br /> Signature'of Generator,Representative or Mont of Generator: X paite'�
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<br /> Recycling,Transfer,Treatment,Storage, Disposal Facilities Nama: !I`
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<br /> I ' Address: li i
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<br /> Bakersfield Transfer California Oil
<br /> 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 95691 Yuma,AZ,85365 Phone:
<br /> 661.322.8256 209.863.8181 916.371.5747 928-344.9826
<br /> CAL00028256 CAL0000190811- CAD004003566 AZR000515924 EPA ID:
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