COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

poll Environmental Services Division I Mailing; P.O. Box 176, Salida , CA 95368 . 1f' Consolidated Manifest get3KbmanGourt, Sarrdp, CAB3ae9 Phone ; 209-545.0781 FAX 209.545.2241 A PETROLEUM PRODUCTB COMPANY Invoice EPA # CAR000047019 CA Transporter Numbor 3844 CA License # 758518 GENERATOR : Invoice No 40 Site EPA ID #: r . Invoice Date ; fipill, rid, Contact Person : Driver Printed Signature: pf Name : Truck #: Address : PON City, State, Zip Site Phone : TERMS : Product Shipping Name Waste CA Manifest #0 Quantic units Code Y Price Amount imold N0n•RCRA Hazardous Waste Liquid (Used Oil) : Lubricating 221 Gal Non-RCRA Hazardous Waste Liquid ( Used Oil): Industrial 221 cat dIdInd Non RCRA Hazardous Waste Liquid (Used Automotive Antifreeze) 134 Gal Non-RCRA Hazardous Waste Liquid (Oil & Water) 223 lip ; cal Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 jDrum(s) Paper and/or Plastic Oil Filter Drum(s) 352 Drum(s) Drained Used Oil (Metal) Filter Drums) s each WoodI Empty Drums) Each Transportation & Truck Time HR. 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 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%, 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 pprn, and 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 to accept the additional charges for the disposal of the waste if the information I have provided about this waste is incorrect. 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 generated to the degree I have determined to be econornically affordable and that I have selected the practicable method of treatment, storage, or disposal currently 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 minimize my waste generation and select the waste management method that is available to me that I can afford . 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 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 hazardous waste management facilities . California facilities that handle or process Used Oil and Oily/Water are required to meet those more stringent requirements , and some out-of-state facilities that process Used Oil and Oily/Water also meet those requirements, engineering certifications of tank integrily, and financial assurances for 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 standards and not these more stringent requirements . This notification is for the informational purposes only. 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 waste has been transported to a permitted transfer facility or permitted treatment, storage or disposal facility, Lowry Driver Signature X 11j, Date ' -• Signature of Generator, Representative or Agent of Generator: X Date s Recycling , Transfer, Treatment , Storage , Disposal Facilities (� Name: Fr 0 j I i Address : ' Bakersfield Transfer California Oil Transfer LLC Ramos Environmental Salto Oil Recycling , Inc, City, State, Zip : 1620 E. Brundage Lane 5300 Claus Road 1515 S . River Road 1217 S. Fiesta Ave. Bakersfield, CA 93307 Riverbank, CA 95367 West Sacramento, CA 95691 Parker, AZ 85344 Phone: 661 .322.8258 209.863 .8181 916.371 .5747 928 .854-3202 CAL000282598 CAL000190816 CAD044003556 AZR000516181 EPA to: