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c <br /> ate ERA dlS.# <br /> 4 i a I i:.° i n6e'�e 7 618� ' a t• tad 3 <br /> 7. <br /> Contact Person, Consolidated Manifest lnvofce; <br /> Name. 443 <br /> Address: ' Shipment Date: " <br /> City,State,zip: , ^ Driver Signature{Printed).— <br /> Site Phone; p Truck# . <br /> PQ# <br /> Product <br /> ' 6nRC(1q t waste <br /> � iqujd Nrdous Waste III <br /> sed oil) code CA:f <br /> Nit-RC RA H r�us Waste ubrtrabng 221 1 QuarttRy � <br /> aZa '`� <br /> �igtrid(Used #"7 Price �Fq„,,unt <br /> f <br /> N R Hazarttous w oilj:1ndtlsfr8at 221 Gat e '' :r <br /> Non-RCRA �id(�dAutor►n�Anf SSM) 134 <br /> FZardots Waste Uquw(()#&Waw) , Gat <br /> +` -RCRA Hazardous W 221 ; Gat <br /> rife Som.CorNaminated with Used o7 ^� <br /> ro Used Ot7 F` t)'�►Ks) 223 Gar " <br /> nrt,nK,y <br /> Transportation IN T,uck`TayinZ. <br /> o^+rtKa' _�, <br /> Hazanii,Test 1 <br /> MR <br /> urns ye�rW a�tws <br /> ceipt <br /> CAGE att blee�PFRrest o �y rer�. ourue <br /> Ta aft-srAt l"Ont",due <br /> ani t loth ftremond <br /> Ining this receipt the lien ft ANNA PERCENT m oft chase. PaBt <br /> nines Generator �E RATE cr 18� 0, ILP-1 E C'';" E I VE D <br /> ator rtiHes gthQat y steU ted o �has been established to reduce the volume or qua <br /> .George W-used Oil Lowry.Inc.hereby advises ll "Widated Menite9t a.celtpt 18 pronled nientthe Viand toxicity of the h¢ N 0 V 2015 <br /> M ay be transported to 2 es the Generatorthat X Codes as listed e <br /> uired to compty wtih- facil <br /> s user(oil ae more s dY that is required ep ed to co p y uvifh fe ENVIRONMENTAL <br /> Thi InCludetyrequired t meet thomorese utrwnents applicable t h l drat regulations HEALTH DEPARTMENT <br /> ire and a sttingent leak de stringent requirements, hazardous waste man applicable to m <br /> Id n dental releases. itis lection and prevention sorrte o,ast s agement f8atlitieS C <br /> of these more and <br /> stringent. lawful to send used oil to requirements engineering t'�s that prof . <br /> This nottti g it <br /> out of state faCll'' g fifes <br /> of <br /> cation is11 rhes that comply only tankr <br /> for tnforrnation only. to a the Few, <br /> Lowry Driver Signature X <br /> ?Of Generator,Re <br /> Generator, <br /> orq <br /> Agent of Generator: X { !p <br /> 15131E.C�rProcessing,Inc. Recycling <br /> ji <br /> 4110119 <br /> !nd anus,t3ld . CRI i <br /> ustry,CA 91745 9 E 101 Hagen pave <br /> 526.333.5617 Woodville,vw <br /> � <br /> ing CAt.000097432 715.698-3363 54028 Name. r <br /> WIR"0029751 <br /> tS Address:` <br /> Riverbankl old Address: <br /> 5306 �a o� vt c ;! <br /> Rondo" �" ""-------� <br /> Riverbank,CA ty, tat zit <br /> 209-8193-8;8j <br /> 4t OQ®1;81 X387 15 S.River Road t ,s e 1 i <br /> 90817 9 'Incram7t 47el CA 95691 <br /> Prone: <br /> 558 <br /> � <br /> C �� EPA to: I <br /> . j <br /> 3 <br />