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ry Mailing:P.O.Box 176,Salida,CA 953680 <br /> 4612 Kiernan Court,Salida,CA 95368 <br /> George W. Lowry, Inc. Phone:209-545-0791 FAX 209-545-2241 <br /> Environmental Services Division EPA#CAR000047019 <br /> ' "ate CA Transporter Number 3844 <br /> CA License#758518 <br /> GENERATOR: <br /> Site EPA ID#: � i�%> . t i Consolidated Manifest Receipt: <br /> Contact Person: Shipment Date: - <br /> Name: tr `�, w <br /> Driver Signature: r. <br /> Address: l i 00 T l f <br /> City, State, Zip: ! f Truck# <br /> Site Phone: <br /> Product Waste Manifest 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) 135 GAL <br /> j .• - r— . <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 GAL <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 221 GAL <br /> Drained Used Oil Filters Drum(s) <br /> Waste Solids&Sludge <br /> Wash Out <br /> EA. <br /> Empty Drums <br /> ransportation&�Tckme HR. ` /! <br /> i <br /> Hazardous Test +. <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, <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 /> ,� 3 Go <br /> By signing this receipt, <br /> i t,the Generator certifies that a program has been established to reduce the volume or quantity and toxicity of the hazard o�Llb'4vaste to <br /> a degree as determined by the generator,to be economically practicable. <br /> Consolidated Manifest Receipt is profiled to meet the Waste Codes as listed above.. <br /> Generator certifies that all Hazardous Waste listed on this <br /> Signature of Generator, Representative or Agent of Generator: x <br /> Recycling 8� Disposal Facilities <br /> 0 0 <br /> ISreenleaf Environmental Americlean Name: <br /> 3474 Toyon Cr. 2430 Almond Dr. <br /> Valley Springs,CA 95252 Silver Springs,NV 89429 <br /> 209-754-4600 775-577-9001 Address <br /> CAL000214411 NVD982358483 <br /> City, State,Zip: <br /> iverbank Oil Transfer CRI Recycling Service,Inc. <br /> 5300 Claus Road 101 Hagan Drive Phone: <br /> Riverbank,CA 95367 Woodville,WI 54028 <br /> 209-863-8181 715-698-3363 cnA In- <br />