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adORECEIVED <br /> MailingA Box 176,Salida,CA 95368 <br /> 4612 Kiernan Court,Salida,CA 95368 <br /> George W. Lo ry, Inc. NOV 2 0 2015 phone:209-6454791 FAX 209-545-2241 <br /> Environmental Services Division EPA#CAR000047019 <br /> ENVIRONMENTAL CA Transporter Number 3844 <br /> HEALTH DEPARTMENT CA License#758518 <br /> GENERATOR: Consolidated Manifest Invoice: <br /> Site EPA ID#: <br /> Shipment Date:, <br /> Contact Person q <br /> Driver Signature(Printed)', <br /> Name t( e 4 <br /> Address: ' Truck#'c <br /> w. <br /> 4 trJ <br /> City,State,Zip PO# <br /> Site Phone: <br /> Product Waste CA Manifest 00 Quantity Units Price Amount;' <br /> Code <br /> ,- ., ,� �.:. a <br /> n.-RCRA Hazardous Waste Liquid(Used Oil):Lubricating 221 , va; `;g Gal r <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Industrial 221 Gar <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 Gat <br /> -RCRA Hazardous Waste Solids Contaminated with Used Oil 223 ,�;' e .";f Dn""t°► <br /> n <br /> d Drained Used Oil Fitter Drum(s) Drums) <br /> Empty Drum(s) Elich <br /> Transportation&Truck Time <br /> Hazardous Test <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms: Accounts due on the 1011 of the month fdibwing month of purchase. Past due Total --i " <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%per month,which is the ANNUAL PERCENTAGE RATE of 19%. ; €, <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 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 out-o"tate facilities that process used of 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 ._ r <br /> Signature of Generator,Representative or Agent of Generator: X <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,W154028 Name' <br /> 209-7544600 7156983363 <br /> GAL000214411 ;r' WIR000029751 Address: <br /> Recycling '� <br /> &Disposal ' Inctrl.State.Zip: <br /> Facilities AiVarbank`Oil Transfer 5300 Ramos Environmental <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 2098638181 916371-6747 <br /> CAL0000190817 CAD004003566 EPA ID: <br />