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RECEIVED Mailing S Box 176,Salida,CA 95368 <br /> 4612 Ki an Court,Salida,CA 953658 <br /> tGeorge W. Lolwg, Inc. Phone:209-545-0791 FAX 209-Silli-2241 <br /> 4 <br /> NOV 2 ® 2015 <br /> Environmental Services Division EPA 0 CAR000047019 <br /> CA Transporter Number 3844 <br /> ENVIRONMENTAL CA License#758518 <br /> HEALTH DEPARTMENT <br /> GENERATOR: Consolidated Manifest Invoice: <br /> Site EPA ID# <br /> Shipment Date: <br /> Contact PAArson: <br /> Driver Signature(PrintQ'q., <br /> Na <br /> Address. " Truck <br /> City,State,Zip: <br /> PO# <br /> Site Phone: <br /> Product <br /> wast. CA Manifest NO Quantity units Price Amount <br /> Code <br /> Gal <br /> 'RCRA Hazardous Waste Liquid(Used Oil):Lubricafing <br /> 221 <br /> -Non- Y. <br /> Gal <br /> Non-RCRA Hazardous Waste Liquid(Used 00):Industrial 221 <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 223 Drums) <br /> Drained Used Oil Filter Drum(s) Drum(s) <br /> Empty Drum(s) Each <br /> Transportation&Truck Time HR <br /> Hazardous Test <br /> Unless otherwise specified on this Consolidated Manifest Receipt(Invoice)Terms: Accounts due on the 1001 of the ffmM fORMSM month of PurChaSE). Past due Total <br /> accounts YAII be chaived a FINANCE CHARGE at the PERIODIC RATE of 1 A r2%per inonth,which is the ANNUAL PERCENTAGE RATE of 18%. <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 asi <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 Federal used oit,managprdieiii stan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry Driver Signature X,.-�' <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 95262 Woodville,W11 54028 <br /> 209-754-4600 7156983363 <br /> bAl-0002144111 VWIR000029751 Address: <br /> Recycling <br /> &Disposal Boa city,State,zip: <br /> Facilities Ri#prYmhk Oil Transfer 5300 Ramos Environmental <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209-8633-8181 916371-6747 <br /> CAL000019W17 C 355 EPA ID: <br />