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Mailing:P.O.Box 176,Salida,CA 95368 <br /> RECEIVED <br /> 4612 Kiernan Court,Salida,CA 96368 ;ffi <br /> '•.GaOf qB W. L®Wii'y, 'C1C. q Phone:209545-0791 FAX 209.545.2241 <br /> x. <br /> l EnviropmentalServices Division ii NOV L�IJ EPA#CMOOW47019 <br /> _ CA Transporter Number 3844 <br /> CA license#758518 <br /> ENVIRONMENTAL <br /> GENERATOR: HEALTH DEPA ITME 41 <br /> Consolidated Manifest Invoice: ?<<4 ; <br /> Site EPA ID A, Shipment Date: / <br /> Contact Penson: <br /> Name: Driver Signature(Printed <br /> Address: Zl Truck# <br /> City,Ste,21p: - AA-1 PO# <br /> Site Phone: <br /> Product waste CAManifest#0 Quantity units PAW Amount <br /> Code <br /> ,Non-RCRA.Hazardous Waste Liquid(Used Oil):Lubricating 221 '` �/� Gal (� <br /> Non-RCRA Hazardous Waste Liquid(Used Oily:Industrial 221 �( (,j � Gat <br /> Non RCRA Hazardous Waste[Auld(Used Automotive Antifreeze) iso Gar <br /> Non-RCRA Hazardous Waste Liquid(01&Water) 221 Get <br /> Non-RCRA Hazardous Waste Sobs Contaminated with Used Oil 223mla9 <br /> Drained Used Oil Filter Druln(s) Drumtsl <br /> Empty Dwin(s) Each <br /> Transpodaft&TnickTime HR <br /> Hazardous Test <br /> intoes otherwise specified on this C Manifest Receipt(Invoice)Ferns:Accounts duo on the 1�cs the nandli f lowinti month of pwchase.Past due Teta <br /> accounts will be charged a FINANCE CHARGE at Me PERIODIC RATE of 1-12%pw nwn0%which a the ANNUAL PERCENTAGE RATE of 18%. f <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 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 facliity 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. 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 teak 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 thatcomply only with the Fecteffi,'used ON management Stan- <br /> dards,and not these more stringent requirements. <br /> This notification is for information only. Lowry Driser Ignatwl <br /> r <br /> 'Signature of Generator Representative or Agent of Generator. if) / <br /> Ig p if <br /> Greenleaf Environmental 9JRacy.. <br /> 3474 Toyon Cr. 101 Hagen Dove <br /> Valley Springs,CA 95262 Woodville,VYi 54028 Nom' <br /> 209-7544600 715.698.3363 <br /> C.AL00D214411 WIR000029751 Ay . <br /> n <br /> g /� f fal \R verbank Oil Transfer 5300 Ramos Environmental c�� �P <br /> Claus Road 1615 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 96691 Phone: <br /> 209.863.8181 916371-6741 <br /> CAL0000190817 CAD0040035M EPA to, <br />