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py <br /> 051VEb <br /> A'O" 0 O Mailing:P.O.Box 176,Salida,CA 95368 <br /> Iv V 4612 Kieman Court,Salida,CA 95368 <br /> George W. LOWCy, Inc. i Phone:209.545.0791 FAX 209-54s-2241 <br /> "�- ENVIRONMENTAL <br /> Environmental Services Division EPA#CAR000047019 <br /> DEPARTMENT CA Transporter Number 3644 <br /> j CA License#758518 <br /> . ..� r <br /> GENERATOR: <br /> Consolidated Manifest Invoice: 2 4 3 1 0 <br /> Site EPA ID .`Y, -Keg115, _--/y 3 <br /> r Shipment Date: U <br /> Contact Person: <br /> Name: '6 Driver Signature(Printe�"`���t' <br /> Address: 1 �, i/_l/1 /. �/r (d'� Truck# < .� <br /> City,State;Zip: ? Js�J <br /> PO# <br /> Site Phone: <br /> Product Waste CA Manifest#0 Quantity units PriceCode <br /> giro nt ! <br /> a flonzRCRA Hazardous Waste Lilluid(Used Oil);Lubricating 221 <br /> Nat-RCRA Hazardous Waste Liquid(Used Od):Industrial 221 f Gal <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 rat <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 <br /> Noon-RCRA Hazardous Waste Solids Contaminated with Used Cif 223 D-In(s) <br /> Drained Used oil Filter Drums) "" D"""(s► `7 � ,• "" <br /> Empty Drum(s) r..�— Ejah <br /> Transportation&Truck Time NR. <br /> Hazardous Test <br /> Untess otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th of hhe month following month of purchase. Past due Total —..=. <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 14r2%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 degreeJ4 <br /> determined by the generator,to be economically practicable. <br /> Generator certifies that all Hazardous Waste listed on this Consolidated Manifest Receipt-s'profiled to meet the Waste Codes as listed above. <br /> Note: George W. Lowry,Inc.hereby advises the Generator that X f s s(Generator's signature) <br /> shipment of used oil may be transported to a facility that is required to comply 'th 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. Califomia facilities that handle or <br /> process used oil are required to meet those more stringent requirements,and some out-of-state facilities that process used oil also meet those require- <br /> ments 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 facilities that comply only with the Federal used oil management stan- <br /> dards and not these more stringent requirements. / <br /> This notification is for information only. Lowry Driver Signature X "�. �lr <br /> Signature of Generator,Representative or Agent of Generator: X <br /> Greenleaf Environmental CRI Recycling <br /> 3474Toyon Cr. . 101 Hagen Drive <br /> Valley Springs,CA 9525 Woodville,WI 54028 Name. <br /> 209-7 00 718-698-3363 <br /> ReC Curl CALF 4 4411 MR000029751 Address: <br /> y g <br /> 8r Disposal ; <br /> Facilitiescity,sate,zip: <br /> Ri�v'erbank Oil Transfer 5300 Radios Environmental <br /> Cratkftoad 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209-863-8181 916371.5747 <br /> CAL0000190817 CAD004003556 EPA ID: <br />