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RREC"EIVED <br /> Mailing:P.O.Box 176,Salida,CA 95368 <br /> 4612 Kteman Court,Salida,CA 95366 <br /> George W. Lowry Inc. NOV. 2015 Phone:209-546.0791 FAX 209-54S-2241 <br /> Environmental Services Division EPA#CAR000047019 <br /> �'"—{' CA Transporter Number 3844 <br /> ENVIRONMENTAL CALicertse#758516 <br /> a. <br /> HEA1 1H 12 NT <br /> GENERATOR: <br /> ! �\ (L�,? t� Consolidated Manifest Invoice: t3 <br /> ' Site EPA ID#: ..J <br /> 494 4 <br /> Shipment Date: ,� _ / r �/ <br /> Contact Person: f <br /> Name: Driver Signature(Printed): �r. s <br /> r Address: 2 Truck# <br /> City,state,Zip: < fCA <br /> FO# <br /> Site Phone: <br /> Product waste CA Manifest#0 Quantity, units Prue Amount <br /> Code <br /> Non-RCRA Hazardous Waste Liquid(Used o0):Lubricating 221 / ;r, •-� ` h /(� Gal j'r' �b <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Industrial 221 ! r-r410. <br /> Y � 1 <br /> Non RCRA Hazardous Waste liquid(Used Aulorriative Antifreeze) 134 Gat <br /> Non-RCRA Hazardous Waste Liquid(Ori&Water) 221 Gal <br /> Nal-RCRA Hazardous Waste Solids Contaminated with Used Ole 223 <br /> Drained Used OR Finer Drum(s) �rnh(sl <br /> Empty Drum(s) Each <br /> Transportation&Tmdt Time tin. <br /> Hazardous Test <br /> Uniess otherwise specified on this Consolidated Married Receipt(Invoice)Terns:Accounts due on the 1fh of the mann~(Duawing month of purchase. Pass duo Total <br /> axons win be charged a FINANCE CHARGE at the PERIODIC RATE of 1-112%per month,which is the ANNUAL PERCENTAGE RATE of 187. <br /> By signing this receipt the Generator certifies that a program has been established to reduce the volume or quantity and to)ictty of the hazardous waste to a degree as <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 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 ouW-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 faclli k!Eitiat� ly only with the Federal used all management stan- <br /> dards tri <br /> and not these more stringent requirements. '�-� <br /> This notification is for information only. Lowry Driver Si dature X <br /> Signature of Generator,Representative or Agent of Generator:6�) irv� s' <br /> V <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,WI 54028 Name: <br /> 209-754-4600 715.6983363 <br /> CAL000214411 WM000029751 Address: <br /> Recycling <br /> 8h Disposal cit)4 state,zip: <br /> Facilities Riverbank Oil Transfer 5300 Ramos Environmental <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone- <br /> 209-863-8181 916371-5747 <br /> CALCOOD190017 CA13004003656 EPA to: ! <br />