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rRECENEU <br /> Malling:P.O.Box 176,Salida,CA 95368 <br /> NOV 2015 4612 Klentan Court,Salida,CA 95368 <br /> George W. Lowry, Inc. Phone:209-545-0791 FAX 209-545-2241 <br /> Environmental Services Division :' EPA#CAROOOD47019 <br /> ENV MENTAL CA Transporter Number 3844 <br /> HEA PARTMENT CAucense#758518 <br /> GENERATOR: Consolidated Manifest Invoice: <br /> Site EPA iD#. ,9a S Shipment Date: <br /> Contact Pers <br /> Nom. rr1 Driver Signature(Printedd`�, <br /> Address: I�" p � ���� � r� /( Truck# 11-7— <br /> City, <br /> 1-7—City,State,Zip: S• / *g�l 4 <br /> t?O# <br /> Site Phone: <br /> Product waste CA Manifest#0 Quantity units Price Amount <br /> Code <br /> ton- CRR Hazardous Waste Liquid(Used 00:Lu1 fbricating 221 T11 i l�ai 13 <br /> Non-RCRA Hazardous Waste Liquid(Used 011):Industrial 221 Get <br /> Non RCRA Hazardous waste Liquid(Used Automotive Aniifieeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 Gal <br /> Nal-RCRA Hazardous Waste Solids Contaminated with Used Off 223 <br /> Drained Used Oil Poet Dium(s) neumta} <br /> Empty Drum(s) Each <br /> Transpoftffon&Truck Time HR. <br /> Hazardous Test <br /> Unless oghemw specified on this CaisokMed Mandest Receipt(kwcico)Tema:Accounts due on the M of dw march Wowtnp mordh of purchase. Past due Total <br /> accounts wig be drarged a FINANCE CHARGE at the PERIODIC RATE of 14120A per month,whidi 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 was to a degr Pl/ -. <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 Codas 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 of are required to meet those more stringent requirements,and some out-of-state facilities that process used ori also meet those requi <br /> ments These include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and financial.,�.sd-,a <br /> for closure and accidental releases. It is lawful to sand used oil to out of state facilities that comply only with the Federal used oil nl nagi:trtenfan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry DriverS' `ature X f <br /> � 1 <br /> Signature of Generator,Representative or Agent of Generator: X �---=-------- <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs CA 95252 Woodville,Vill 54028 Name, <br /> 209 754-46 Springs, <br /> 11 WIRO00029751 Address; <br /> C3 State,Zip. <br /> Recycling <br /> &Disposal <br /> Facilities ive' ank Oil Transfer 5300 Ralttos Environmental City.Claus Road 1815 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209-863-8181 916-3715747 <br /> CAt-0000190817 CAD00400355$.; EPA io: <br /> 0 <br />