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Mailing:P.O.Box 176,Salida,CA 95368 <br /> 4612 Kiernan Court,Salida,CA 95368 <br /> George W. Lowry, Inc. Phone:209545-0791 FAX 209-545-2241 <br /> Environmental Services Division EPA#CARD00047019 <br /> CA Transporter Number 3844 <br /> CA License#758518 <br /> GENERATOR: Consolidated Manifest Invoice: <br /> Site EPA ID#: �.Shipment Date: i -- <br /> Contact Person: <br /> Name: i/. .7 driver Signature(Printed): <br /> Address: Truck# } <br /> City,State,Zip: <br /> PO# <br /> Site Phone: <br /> Product 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) 221 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 223 DrunXs) <br /> Drained Used Oil Filter Drum(s) Drurn(s) <br /> Empty Drum(s) Each <br /> Transportation&Truck Time HR. <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 1-12%per month,which is the ANNUAL PERCENTAGE RATE of 18%. <br /> By signing this receipt,the Generator certifies that a program has been established to reduce the volume or quantity and toxicity of the hazardous waste to a degree as <br /> determined by the generator,to be economically practicable. <br /> Generator certifies that all Hazardous Waste listed on this Consolidated Manifest Receipt is profiled to meet the Waste Codes as listed above. <br /> Not"' �7,eorrrt?b'Sr- 10WrV !r c hereby advises the -:'Cneratol that s Generator's signature) <br /> shipment of used oil may be transported to a facility that is required to comply with federal regulations applicable to management of used oil but that Is <br /> not required to comply with the more stringent requirements applicable to hazardous waste management facilities. California facilities that handle or <br /> process used oil are required to meet those more stringent requirements,and some out-of-state facilities that process used oil also meet those require- <br /> ments These include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and financial assurances <br /> for closure and accidental releases. It is lawful to send used oil to out of state facilities that comply only with the Federal used oil management stan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry Driver Signature X <br /> r <br /> , <br /> Signature of Generator,Representative or Agent of Generator: X -_- __f_ _ `-✓ ;x:. °r <br /> C3 C3 S <br /> Greenleaf Environmental CRI Recycling /) <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,WI 54028 Narns: <br /> 209-754-4600 715598-3363 <br /> CAL000214411 WIRD00029751 arc <br /> Address: <br /> Recycling <br /> &Disposal Q 0 ,t <br /> City,State,' 'S-�rl.lam' ( ,41 <br />