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Environmental Services Division '(7GEI:ORGEINC. Melling-P-O Box 176,Salfda,CA 95368 �OnSO�f�� g�E�� 4612 Kiernan Court,Safida,CA95368 OWRY s 6[ ! Phone•209-545-0791 FAX 209-545-Mi PRODUCTS COMPANY Invoice EPA#CAR000047019 Invoice b6 CA Transporter Number 3844 CA License P 758518 GEMERATOR- Invoiceboy 40 , & Site EPA ID 9. Invoice Date: Contact Person: Driver Printed Signature: Name: Truck 9: Address: PO# City,State,Zip. Site Phone: TERMS: Product Shipping Name Cads CA Manifest#0 Quantity units primo Amount Non-RCRA Hazardous Waste Liquid(Used Oil) Lubricating 221 Gal Non-RCRA Hazardous Waste Liquid(Used Oil). Industrial 221 Gal Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Cel Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal Non RCRA Hazardous Waste Solids Contaminated with Used Olf 352 ,;,s,. ,• Drum(s) r U.r— Paper andlor Plastic Oil Filter Drum(s) 352 Drum(s) Drained Used Oil(Metal)Filter Drum(s) Each Empty Drum(s) Each Transportation R Truck Time � �� HR. CD Unless otherwise specked on this Consolidated Manifest Receipt(Invoice)Temis Accounts due on the 10th of the month following month of purchase Pasi duo Total < r p accounts will be charged a FINANCE CHARGE at the PERIODIC RATE.of 1-112%per month,which is the ANNUAL PERCENTAGE RATE of 18% S 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 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 d the information I have provided about this waste is incorrect Generator's Certification By signing 1 certify that If I am a large quantity generator, I certify that I have program in place to reduce the volume and toxicity of vraste generated to the degree I have deternuned 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 applicaLie 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 integrity,and financial assurances for closure and accidental releases,a is lawful to send Used ail and OilylWater 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 rt 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 Date Signatum of Gianerator,Representative or Agintof Generator: -X hate Recycling,Transfer,Treatment,Storage, Disposal Facilities i Name: Q13 !^L I Address: Bakersfield Transfer California Oil Transfer LLC Ramos Environmental Sako 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:_ 651,3-22-8258 209-863-8181 916-371-5747 926-864-3202 ! j CAL000282508 CAL0001908% CADOW03656 AZR000516181 EPA I� 11=