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RECEIVEDMailing:P.O.Box 176,Salida,CA 9511611 c. <br /> 4612 Kiernan Court Salida,CA 95368 <br /> George W. Lowry, Inc. 11 NOV 0 2015 Phone:209-64.S.0791 FAX 209-545-2241 <br /> ...............12— <br /> Environmental Services Division i. EPA#CARODOU7019 <br /> V RO `SEN <br /> TAL TMENT CA Transporter Number 38" <br /> ENV' CA License#758618 <br /> HgLLTH _ <br /> GENERATOR" Consolidated Manifest Invoice: <br /> 2 4672 <br /> Site EPA ID M 7J00 -SR9 4!T,12 Shipment Date: <br /> Contact Person. <br /> Name: Driver Signature(Printed) Crim <br /> Address* Truck# <br /> City,State,Zip: PO# <br /> Site Phone: <br /> Product waste CA Manilest#0 Quantity Units paw Amount <br /> Code <br /> -Non-RCRA Hazardous Waste Liquid(Used 011)11.1bit8ling 221 nj,Z44-_7,> <br /> Zs <br /> Non-RCRA Hazardous Waste Liguld(Used Oil):Industrial 221 - ------ <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 <br /> Non-RCRA Hazardous Waste Liriuid(01&Water) 221 Gal <br /> Non-RCRA Hazardous Waste Sofids Contaminated with Used Oil 223 Drum(a) <br /> Drained Used OR Fifier,Drum(s) Murals) <br /> Each <br /> Empty Drum(s) <br /> Transportation liTruckTimia HR <br /> Hazardous Test <br /> 60 <br /> LM119ss otherwise simMed an this Com;oWaiW Manirest Receipt(Invoke)Term:Acwunts due on the 10th of the ffmO folowirM mong)of P=hM.Past dug <br /> accounts win be charged a FINANCE CHARGE at ft PERIODIC RATE of 1412%per month,which is ft ANNUAL PERCENTAGE RATE of 118%_ Todl <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 11�tas <br /> determined by the generator,to be economically practicable. <br /> Generator certifies that all Hazardous Waste fisted 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 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 FedeLat used oil management stan- <br /> dards and not these more stringent requirements. <br /> This notification Is for Information only. Lowry Driver Sign <br /> Signature of Generator;Representative or Agent of Generator: X <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Tayon Cr. 101 Hagen Drive <br /> Valley Springs,CA 96252 Woodville,W!64028 <br /> 209-7544600 7115-698-336i <br /> CALOOD214411 WVIRD00029761 Address: <br /> ReCyCling r <br /> $DisposalM city.state-zlir <br /> Riverbank ON Transfer 5300 Ramos Environmental <br /> Claus Road 1515S.Rivet Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209-863-8181 916374-6747 <br /> CALOODO190817 CAD00400306 EPA[D* <br />