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Maifing:P.O.Box 1T6,Salida,C 44EOUEIVELJ <br /> ,. l 4612 Merman Court,Salida,CA 96368 <br /> U_Gaeoroa �-OW $ II1C. !•;; Phone:209545.0791 FAX209-546.2241 <br /> ental Services Division EPA#CARO00047018 FEB 2016 <br /> CA Transporter Number 3844 <br /> CA License#758518 ENVIRONMENTAL <br /> HEALTH DFRARTMENT <br /> GENERATOR: f Consolidated Manifest invoice: 91 <br /> }"'a <br /> Site EPA ID <br /> `"``I " <br /> p� <br /> Contact Person- Shipment Date: <br /> Name: A�i Driver Signature(Printed),""•• <br /> r ��e � <br /> Address: J Truck <br /> city,State,zip: a.-- <br /> S(te Phone: r , PON <br /> Product Waste CA Manifest#0 ®uanGty units Price Dunt <br /> Code <br /> RC-RA Hazardous Waste Liquid(Used 00):Lubricating 221 <br /> 74 <br /> Non-RCRA Hazardous Waste Liquid(Used C*):Industrial 221 Gat <br /> Non RCRA Hazardous Waste Liquid(USW Aubmotive AnttTmm) 134 slat <br /> Non-RCRA Hazardous Wash Liquid(Orn&Water) 221 Gal <br /> ' -RCRA Hazardous Wash Solids Conhaminated with Used Oil 223 y <br /> `- Drained Used 01 Filter Drum(s) <br /> v�•�-� <br /> Empty Drum(s) Each <br /> Tra &Truck Time HR. <br /> Hazardous Test <br /> unless athenvise specified on On Consolidated Manifest Receipt(imofos)Termer Accourds due on the 10th of"month t °-�°`') <br /> acoamts-1111 be d-wd a FINANCE CHARGE at Om PERIODIC RATE of 7-11274 per month,which is the ANNUAL PER GE RA•rE of 18% <br /> Past due Total v <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 profited to meet the waste Codes as listed above. <br /> Note:George W.Lowry,Inc.hereby advises the Generator that X 's(Generator's signature) <br /> shipment of used oil may be transported to a factltgr 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 ouW-state facilfies that process used oil also meet those require- <br /> ments These include more stringent teak detection and prevention requirements,engineering certifications of tank integrity,and financial as Ices <br /> for closure and accidental releases. It is lawful to send used ON to out of state facilldes that r�mpiy only wl�ft the Federal used oil mane lit stan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry Driver Signature X <br /> r <br /> Signature of Generator,Representative or Agent of Generator. XI <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr: 101 Hagen Drive <br /> Valley Springs,CA 95252 wootivilte,WI 54028 Name: <br /> 209 T554q.4q4�000p 715696,3363 <br /> ROC C1it1 <br /> jAL0'Uk441! WIROOOD29761 Addrace: <br /> Y g off <br /> &UlSi30Sali <br /> Facilities ok O Transfer 5300 Ramos Environmental coq �'m'gyp' <br /> Claus Road 1615 S.RiverRoad <br /> Riverbank,CA 96367 West Sacramento,CA 95691 r%no: <br /> 209.8638181 916371.5747 <br /> CALOOOD190817 CAD0040035SS EPA ID: <br />