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Environmental Services Division <br /> 400GOEORGEINC. Marling P.O.Box 175,Salida,CA 95368 <br /> a 4612 Kiernan Court,Salida,CA 95368 <br /> �r�l <br /> gr!t <br /> Cons®fidated Manifest Phone:209-6454791 FAX 209545-2241 <br /> COMPANY nvo Invoice <br /> i ce EPA E CARO00047019 <br /> E 1 tl F/ G CA Transporter Number 3544 <br /> CA License#7sema <br /> GENERATOR: Invoice No, 40 <br /> Site EPA ID#: Invoice Date: <br /> Contact Person: Driver Printed Signature: <br /> Name: Truck#: <br /> Address: PO# <br /> City,State.Zip: <br /> Site Phone: TERMS: <br /> Product Shipping Name waste CA Manifest 00 Quantity units Price Arno <br /> Code <br /> Non-RCRA Hazardous Waste Liquid(Used oil).Lubricating 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Oil) Industrial 221 coal <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Cra1 <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(s) <br /> Paper and/or Plastic Oil Filter Drum(s) 352 Drum(s) <br /> Drained Used Oil(Metal)Filter Drums) Each <br /> Empty Drum(s) Each <br /> Transportation&Truck Time <br /> HR. <br /> Uni"s otherwise specified on this Consolidated Manifest Receipt(invoice)Terms Accourds due on the loth ortha month following month of purchase Past due Total <br /> accounts wi6 beic harged a FINANCE CHARGE at the PERIODIC RATE of 1-112%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,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 Caldomia 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,rf 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 cart afford <br /> George W Lowry,Inc hereby advises the above Generator that generators shipment of Used Oil and OIIylWater may be transported to a facility that is required to comply <br /> with federal regulations applicable to management of Used Oil and OilylWater, 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 /> 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 generator that their <br /> waste has been transported to a permitted transfer facility or permitted treatment,storage or disposal facility <br /> Lowry Driver Signature X Date <br /> Signature of Generat®r,-Representative <br /> went of Gerterattsr: X Date <br /> Recycling,Transfer,Treatipent,Storage, Disposal Facilities I <br /> Name: <br /> 0 Qi Q Addream <br /> Bakersfield Transfer California Oil Transfer LLC Ramos Environmental $ako 011 Recycling,Inc. City,State,Zip: <br /> 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 1217 S.Fiesta Ave. f <br /> Bakersfield,CA 93307 Riverbank,CA 95367 West Sacramento,CA 95691 Parker,AZ 85344 I Phone:_ <br /> 661-322-8258 209.863.6161 916371-5747 928-854-3202 <br /> CAL000282598 CAL000190816 CADO44003556 AZROOOS16161 EP� I <br />