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Environmental Services Division <br /> Mailing:P.O.Box 176,Salida,CA 95368 <br /> GEORGEINC. 4612 Kiernan Court,Salida,CA 95368 <br /> l' Manifest Phone:209-545-0791 FAX 209-545-2241 <br /> W.LOWRYEPA#CAR000047019 <br /> (A 7PETROLEUM PRODUCTS COMPANY Invoice CA Transporter Number 3844 <br /> CA License#758518 <br /> GENERATOR: Invoice No- 40001270 <br /> Site EPA ID M Invoice Date: <br /> ' VVI <br /> Contact Person: Driver Printed Signature v, 4S <br /> ,te NName: S- J6 Truck <br /> Address: PO# <br /> City,State,Zip: <br /> Phon,: TERMS: <br /> Product Shipping Name Waste CA Manifest#0 Quantity Units Price Amount <br /> Code <br /> Waste <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221I Gal <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> with Used Oil 352 Drum(s) <br /> Non-RCRA Hazardous Waste Solids ContaminatedV <br /> V� <br /> Paper and/or Plastic Oil Filter Drum(s) 352 Drum(s) <br /> Drained Used Oil(Metal)Filter Drum(s) Each <br /> Each <br /> Empty Drum(s) <br /> Transportation&Truck Time HR. <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms: Accounts due on the 10th of the month following month of purchase. Past due 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%. 1 <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 ppm,and <br /> the waste does not contain any PCB's.I have complied with the requirements of the applicable California used oil management regulation to determine this is true.I agree <br /> to 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 volume 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, 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 to me that I can afford. <br /> George W.Lowry,Inc.hereby advises the above Generator that generators shipment of Used Oil and Oily/Water may be transported to a facility that is required to comply <br /> with federal regulations applicable to management of Used Oil and Oily/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 Oily/Water are required to meet those more stringent requirements,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 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 and Oily/Water management <br /> standards and not these more stringent requirements. <br /> This notification is for the informational purposes only. <br /> m <br /> By both parties signing this invoice it will serve as a gre ent that George W.Lowry,Inc. will submit confirmation for(certain waste streams)to the generator that their <br /> waste has been transported to a permitted tran f it or permitted treatment,nt,storage .sposal facili <br /> ate L, <br /> Lowry Driver Signature X <br /> Signature of Generator, <br /> X, R entati or nt of Generator: X Date <br /> Recycling,Transfer,Treatment, Storage, Disposal Facilities Name: <br /> Address: <br /> 13 13 13 <br /> field Transfer California Oil Transfer LLC Ramos Environmental Sako Oil Recycling,Inc. City,State,Zip: <br /> B 1217 S.Fiesta Ave. <br /> 16 F Phone: <br /> r�fBrundage Lane 5300 Claus Road 1515 S.River Road <br /> Bak .1d,CA 93307 Riverbank,CA 95367 West Sacramento,CA 95691 Parker,AZ 85344 REGOVED <br /> 661-322-8258 209-863-8181 916-371-5747 928-854-3202 EPA ID: <br /> CAL000282598 CAL000190816 CAD044003556 AZR000516161 <br /> WMI 19 <br />