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_ Matting:P.O.Box 176,Salida,CA 95368 <br /> r' 4612 Klernan Court,Salida,CA 95368 <br /> l - ^ <br /> �.GeOPMr�a W. Low.% lftc:, � NOV ® 2015 Phone:209-6454791 FAX 209.645.2241•+: <br /> -YYM.e� ll. iT. <br /> i Environmental Services Division j EPASCAR000047019 <br /> CA Transporter Number 3844 <br /> ENVIRONMENTAL CAUcense#758518 <br /> HEALTH DEPARTMENT <br /> GENERATOR: Consolidated Manifest Invoice: <br /> Site EPA ID#: A4ZV <br /> Shipment Date: <br /> Contact Person: <br /> Nome !! el Driver Signature(Printed): <br /> Address: k Truc # <br /> .�- <br /> city,State,Zip: -�. <br /> Pohl <br /> Site Phone: <br /> Product waste CAManifest#0 Quantity units Price Amount <br /> Code <br /> Non-RCRA Hazardous waste Liquid(Used olp:Lubrkating 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used(XQ:Industrial 221 <br /> Nat RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Nem-RCRA Hazardous waste Liquid(all&water) 227 ;�' '?v� Get <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 223 ��{ e tham(s) PS <br /> Drained Used Oil Finer Drum(s) <br /> _ <br /> Y <br /> Empty Druln(s) ' f Faeh <br /> Transportation&Trt6Time <br /> Hazardous Test <br /> 6 1 <br /> Unless otherwise specified on ids Consotidated Manifest Receipt(Invoice)Terms:Acax is dos on the teAh of the moots following month cf pv:chasa Past dve , TtMa! ✓c. <br /> exaunts ma be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1J2%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 at Hazardous Waste listed 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 K '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 eof used oil but that is <br /> not required to comply with the more stringent requirements applicable to hazardous waste maaagernent facilities. Califomia facilities that handle or <br /> process used oil are required to meet those more stringent requirements,and some out-of-state facilities that puss used oil also meet those require- <br /> inents 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 fati5ties that comply only with the Federal used oil management Stan- <br /> dards and not these more stringent requirements. <br /> i^ <br /> This notification.Is for information only. Lowry Driver Signature X »-.± � <br /> Signature of Generator,Representative'or Agent of Generator: Ij <br /> 40reeiiteaff Environmental CRE Recycling <br /> '.?,3474 Toyon'CP. 101 Hagen Drive <br /> t'\ ;-Valley Springs,CA 95252 Woodville,WI 54028 Name: <br /> 2W7544600 715.898.3363 <br /> �—` i'' Q�iL0b0214411 WIR000029751 Address: <br /> Recycling '�' j .;_ <br /> Cft state,as; <br /> FacIIlBes R,"rbank Obi Transfer 5300 Radios Environmental <br /> _ Claps Roam 2 1515 S.Rlver.Road <br /> RlverbartK.CA 96367 West Sacramento,CA 95691 Phone: <br /> ,209Sfi3 8181 <br /> 916-371-5747 <br /> !CAL000`0'190817 CA00040036W EPA MD <br /> '6 <br />