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` Mailing:P.O.Box 176,Salida,CA 95368 <br /> ti <br /> ECEIVEU <br /> 4612 Kiernan Court,Salida,CA 95368 <br /> George W. Lowry, 1ne. phone:209-54"791 FAx 209-S46-2241 <br /> Environmental Services Division ;' EPA#CAR000047019 <br /> N O V 2015 CA Transporter Number 3844 <br /> CA License#758518 <br /> ENMIBQNMEbff <br /> L <br /> GENERATOR: HEALTH DEPART NT Consolidated Manifest Invoice: ;`' 25463 <br /> i ... <br /> Site EF a lD#: Shipment tate: <br /> Contact Person: <br /> Name: Driver Signature(Printed): K�0� <br /> .. t.rl <br /> Address: ` y Truck# ' <br /> City,State,zip: !"its PO# <br /> Site Phone: <br /> Product waste CA Manifest 90 Quantity Unita Price Amount <br /> Code <br /> on-RCRA Harardaus Waste Liquid(Used 01):Lubricabli 221 / Z C-' ¢6" <br /> Non-RM Hazm*us Waste Liquid(Used 011):Industrial 221 <br /> RCRA Hazardous Waste Liquid(Used Automotive Andheem) 134 �.. p"4�- �(� C'� cal 6 <br /> Non-RCRA Hamnious Waste liquid(Oil&Water) 221 Gat <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used OR 223 <br /> Drained Used Oil R tlar Drum(s) <br /> Each <br /> Empty Drum(s) <br /> Transportation&Trucc Time ttR <br /> Hazardous Test <br /> Unless athenwise Specified on this ManifestRooeV(tnvorce)Tww:Accounts due oaths 10th of the month fa¢owiog month of PUM11aze. Past due <br /> acwunts will be charged a FINANCE CHARGE at the PERIODIC RATE of 14r2%per month,which is the ANNUAL PERCENTAGE RATE of taw <br /> By signing this receipt,the Generator cadifies that a program has been established to reduce the volume or quantity and toxicity of the hazardous wasteto .degr <br /> determined by the generator,to be economically practicabte. <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 oft 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. Califomga facilities that handle or <br /> process used oil are required to meet those more stringent requirements,and some out-of-state.fardlides that process used nil 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 es only with:th;ePZk,�qedgement Stan- <br /> dards and not these more stringent requirements.' <br /> This notification is for information only. Lowry Driver Sigr.7 u V <br /> .Signature of Generga;tor,Representative or Agent of Generator: X <br /> T-1 <br /> own <br /> ENNA <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive Nana: <br /> Valley Springs,CA 95252 Woodville,1N154028 <br /> 209-754.4600 715.696.3363 <br /> CAL000214411 WUM0029751 Address: <br /> RecyClirtg �... <br /> 8c DISpo881 � � �� City,State,ZIP: <br /> FaC(titieS Riverbank Oil Transfer 5300 Ramo nvironme l <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 mtO1a' <br /> 209463.8181 916371.5747 <br /> CAL0000190017 CAD0040035M EPA 1D: <br />