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4� Environmental Services Division <br /> Mailing: P.O. Box 176, Salida, CA 95368 <br /> Arm <br /> 4612 <br /> 1NC . Consolidated Manifest Phone: <br /> 0799 alAX209 4552 <br /> 5368 <br /> Phone: 209.545.078'1 FAX 209-545.2241 <br /> 7019 <br /> A PETROLEUMPRODUCTS COMPANY invoice EPAr CAorter umb <br /> CA Transporter Number3844 <br /> e CA License 41168518 <br /> GENERATOR. - Invoice N ° 40 <br /> Site EPA ID #: Invoice Date: <br /> NOW NNNEMINFIEN <br /> Contact Person: Driver Printed Signature : <br /> Name: . ( Truck #: <br /> Address: PO # <br /> City, State, Zip: W. <br /> NOV <br /> Site Phone: ; TERMS: <br /> Product Shipping Name Waste CA Manifest #0 Quantity units Price Amount <br /> Code <br /> Non-RCRA Hazardous Waste Liquid (Used Oil): Lubricating 221 Gar <br /> Non-RCRA Hazardous Waste Liquid (Used OIQ: industrial 221 Gal <br /> VON <br /> Non RCRA Hazardous Waste Liquid (Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid (0)I & Water) 223 Get <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(s) <br /> Drained Used OU Filter DrumDrum(s) <br /> 1 <br /> Empty Drum(s) Each <br /> Transportation & Truck Time HR. <br /> VOW RMI <br /> mmkift <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 ✓ t, ' <br /> accounts will be charged 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 the <br /> waste does not contain any PCB'st t have complied with the requirements of the applicable California used oil management regulation to determine this is true. I agree to <br /> 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 IV9 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 /> hazardousIwaste management facilities. California facilities that handle or process Used Oil and 011y/Water are required to meet those more stringent requirements, and <br /> some out-of-state facilities that process Used Oil and Ofly/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 OIIyMater management <br /> standards and not these more stringent requirements. <br /> This notification Is for the Infomtatlonal purposes only. <br /> By both parties signing this invoice it will serv"s an agreement that George W. Lowry, Inc, will submit confirmation for (certain waste steams) to the generatorthet their <br /> waste has been transported to a permitted transfer facility or permitted treatment, stgrage`or disposal facility. <br /> Lowry Driver Signature X i �. Date <br /> Signature of Generator, Representative or•Agent of Generator: X ' ` r Date <br /> Recycling, Transfer, Treatment, Storage, Disposal Eacilltles Name: <br /> C3 U. ❑ (� Address <br /> Bakersfield Transfer California 011 Recycling Ramos Environmental Yuma Environmental City, State, zip: <br /> 1620 E. Brundage Lane 5300 Claus Road 1515 S. River Road 2730 E, 13th <br /> Bakersfield, CA 93307 Riverbank, CA 96361 West Sacramento, CA 95691 Yuma; AZ, 85365 Phone: <br /> 6613224258 209.863.8181 916371 .5747 928.344.9826 <br /> CAL00028258 'CAL000019081j- CAD004003556 AZR000515924 EPA 1D: <br />