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Environmental Services Division <br /> GEORGE 4612 i P.O. Box <br /> rt, SSalida, 9 95368 <br /> 368 <br /> ' " � . Consolidated Manifest 4612KIemanCourt, Sallda, CA95368 <br /> OWRY Phone: 209.545.0791 FAX 209-545-2241 <br /> 019 <br /> (A6!PETRIOLEUM PRODUCTS COMPANY Invoice EPA # CA porter Number <br /> CA Transporter Number 3844 <br /> CA License # 758518 <br /> GENERATOR : Invoice N ° 40000555 <br /> Site EPA ID #: OOd 23 Invoice Date : Q — F. �L <br /> Contact Person : Driver Printed Signature : 'LS <br /> Name: 1 V\ P1Ct 6-eox <br /> y Truck #: <br /> Address : sZ ,(,(J , +V)� AL PO # <br /> City, State, Zip: <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 Gal <br /> Non-RCRA Hazardous Waste Liquid (Used Oil) : Industrial 221 Gal <br /> Non RCRA Hazardous Waste Liquid (Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid (Oil & Water) 223 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(s) <br /> Drained Used Oil Filter Drum(s) Drum(s) <br /> Empty Drum(s) Each <br /> Transportation & Truck Time HR. <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 C <br /> 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%. <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's. I 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 life 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 /> 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 OilyMater 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 sery s a reement 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 ansf fac 1ty or permitted treatment; 'St ge r disposal facility. <br /> Lowry Driver Signature Xe <br /> Signature of Generator, Repr s tative orAgent of Generator: X Date <br /> Recycling , Transfer, Treatment, Storage, Disposal Facilities Name: <br /> ❑ Or Di l [3 E3 Address: <br /> Bakersfield Transfer California Oil 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 96367 West Sacramento, CA 95691 Yuma, AZ, 85365 Phone: <br /> 661 -322-8258 209.863.8181 916.371 .5747 928-344 .9826 <br /> CAL00028258 CAL000019081;& CAD004003556 AZR000515924 EPA ID: <br />