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Environmental Services Division G E�RGE Mailing.P O.Box 476,Salida,CA 95368 t"�` Consolidated Manifest Phone:4612 20 -silm7t Sarida,CA95368 K LG�111'Rl/ Phone:209fi45A791 FAR 209di45 2241 A PETROLEUM PRODUCTS COMPANY Invoice EPA#CAR990947019 CA TransporterNumber 3B44 CA License#758518 GENERATOR: Invoice No 40 Site EPA ID#: Invoice Date: Contact Person: Driver Prinied Signature. Name: Truck#: Address: PO# City,State,zip. Site Phone: TERMS: Product Shipping Name Waste GA Manifest 00 Quantity Units Price jAmoCodeNan-RCRA Hazardous Waste Liquid(Used Oil).Lubncabng 221 Gal Nora-RCRA Hazardous Waste Liquid(Used Oil) Industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 cal Nan-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(*) Drained Used Oil Filter Drum(s) Drum(s) Empty Drum(s) Each s Transportation&Truck Time NR. Unless otherwise speafisd on this Consolidated Manriest Receipt(Invoice)T9rms Accounts due on the 1 Dth of the month foil ow,ng month of purchase Past dUE� Total accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-112%per month,which is the ANNUAL.PERCENTAGE RATE of 18*4 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 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 1 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 voiume and toxicity of waste 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 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 OilyMater, 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 iii and Oily/Water also meet those requirements, engineering certifteations of tank Integrity,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 OilyNVater management standards and not these more stringent requirements This itotification is for the informational purposes only By both parties signing this invoice it will serve as an agreement that George W 4;4wry,Inc will submit confirmation for(cetain waste streams)to the generator that their waste has been transported to a permitted transfer facility or permitted treatment,aforage or disposal facility Lowry Driver Signature X Bate Signature of Generator.ReioresentatiVb�erfAgent of Generator:-X tate Recycling,Transfer,Treatment,Storage, disposal Facilities i Name. ❑ ❑ E3 ® Addrser: Bakersfield Transfer California Oil Recycling Ramos Environmental Yuma Environmental `city,state,zip- . 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 Elith Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,85365 Phone: 661-322-8258 209.863.8181 916-371.5747 928-344.9826 f j CP.L00028258 CALtit100190817 CAD004003556 AZR000515924 ;EPA ID. I