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4EG iVEL <br /> J# Mailing:P.O.Box 178,Salida,CA 953 <br /> U.k.-Georae <br /> 4612 Kiernan Court,Salida,CA 96368CCD 2016 <br /> W. Lowry, Inc. a Phone:209S4"'191 FAX 209.545.22411 CDental Services DivisionEPA#CAR000047019 <br /> CA Ttanspoeter Number 3844ENVIRONMENTAL <br /> 4/0 CA Lkense#758518 HEALT14 PRARTNIENT <br /> GENERATOR: per-g -Consolidated Manifest Invoice: y. <br /> site <br /> Shipment Data: ,,,,,, <br /> Contact P n: At 1 >f <br /> Driver#Signature <br /> ignature(PrintenName <br /> Address: � :gTruck s ,. <br /> r <br /> Clty,State,Zip: °" - !if <br /> Site Phone: PO# <br /> Product Waste CAAllanitest#0 Quantity Unita Price Arnountk <br /> � <br /> Code r <br /> on-RCRA Hazardous Waste Ligtiid(Used Oil):Lubricating 221 �� �' Gat >�' <br /> Non-RCRA Hazardous.Waste Liquid(Used 011):Industrial 221 leer <br /> Nal RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 csi <br /> Non-RCRA.Hazaaiotm Waste Solids Contaminated with Used Oil .223 o"s) <br /> Drained Used Oil Filter Dnun(s) <br /> Empty Drum(i) Each <br /> Transportation&Truck rune. HR. <br /> Hazardous Test <br /> unless otherwise speeded an"Cor"Idated Manifest Reosfpt(invoice)Terr m Accounts due an the 10th of the month kftwhV month of pun9tase. Pastdue Total <br /> eccourft will be etargsd a FINANCE CHARGE at the PERIODIC RAM of i-11245 per tri t,which is the ANNUAL PERCENTAGE RATE of 141%. <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 wa to a•d' <br /> determined by the generator,to be economically practicable. <br /> Generator certifies that ail Hazardous Waste fisted on this Consolidated Manifest Receipt is profiled 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 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 ouWf-state facilities that process used of also meet thquire- <br /> ments These include more stringent leak defection and prevention requirements,engineering certifications of tank Integrity.and fioan assyrances <br /> for closure and accidental releases. It is lawful to send used oil to out of state facies that comply only With the Federal used oil man m rk stan- <br /> dards and not them more stringent requirements. <br /> .This notification is for information only. Lowry Driver Signature X <br /> Signature of Generator,Representative or Agent of Generator: X <br /> - A.—I l . <br /> Gieenteaf Enviinnmentat CRI Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> vary SP ngs,CA 9�' ,2 <br /> 52` Woodville,'11111540284 <br /> 7 . 7168983363 <br /> 214411 ' 111114=0029751 address <br /> R@C�tCllrig <br /> Citststo <br /> $c QISt)QSaI Amt <br /> FBCIIItIeS0 Tmnscfer 5300 Rardos Environmental 'zip: <br /> Ci 'd 1515 S.River Road <br /> RI It,CA 96367 West Sacramento,CA 45691 phone. <br /> \ 209.863.8181 916371-6747 ' <br /> CALOODO190817 CAD004003566 EPA ID: <br />