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Environmental Services Division <br /> Mailing:P.O.Box 176,Salida,CA 96368 <br /> 0 RG E INC. — 6 4612 Kiernan Court,Salida,CA 95368 <br /> E <br /> Consolidated Manifest Phone,.209-545-0791 FAX 209-545-2241 <br /> T!R <br /> C <br /> 0 1 <br /> WILOWRY EPA#CAR000047019 <br /> A PETROLEUM COMPANY Invoice CA Transporter Number 3844 <br /> CA License 9 758518 <br /> GENERATOR: Invoice N 4 1 <br /> Invoice Date: <br /> Site EPA ID M <br /> Contact Person: ; Driver Printed Signature: <br /> Name: Truck#: <br /> 'I I AA i,i" <br /> �A <br /> Address, J9 PO# <br /> City,State,Zip: ttr <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 /> T1111i, <br /> Non-RCRA Hazardous Waste Liquid(Used Oil): Industrial 221 Gal <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Non-RGRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-IRCRA Hazardous Waste Solids Contaminated with Used Oil 352 Drum(s) <br /> Drained Used Oil Filter Drum(s) i 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 101h of the month following month of purchase. Past due Total <br /> accounts w 1 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 quanfty 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 Ofly0ater, 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 011y/Waler 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 Oily/Water to out of state facilities that comply only with federal Used 011 and OilyMater 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 serve fA <br /> as an agf�emenat George W.Lowry,Inc. will submit confirmation for(certain waste streams)to the generator that their <br /> waste has been transported to a permitted transfer,fdoilikyor'permitied treatment,storage or dispospl facility. <br /> Lowry Driver Signature XDate <br /> Date <br /> Signature of Generator, Reprep4;�t ive or Agent of Generator; X <br /> Recycling,Transfer,Treatment,Storage, Disposal Facilities Name: <br /> El Address. <br /> E3 <br /> Bakersfield Transfer California 011 ecycling Ramos Environmental Yuma Environmental City,State,Zlp: <br /> 1620 E.Brundage Lane 5300 Claus Road 1515 S.River Road 2730 E.13th Phone: <br /> Bakersfield,CA 93307 Riverbank,CA 96367 West Sacramento,CA 95691 Yuma,AZ,86366 <br /> 661.322-8258 209-863-8181 916,371-5747 928.344,9826 EPA 10: <br /> CAL00028258 CAL0000190817 CAD004003556 AZR000515924 <br />