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Mailing:P.O.Box 176,Salida,CA 95368 <br /> l ti 4612 Kiernan Court,Salida,CA 95368 <br /> ' ra <br /> ':.George W. Lowry,inc. ; Phone:209,546-0791 FAX 209-545-2241 <br /> Envlronmental Services Division EPA#CAR000047019- — <br /> ._ ! <br /> '�• �••-� CA Transporter Number 3844 <br /> CA License#758518 <br /> 1 <br /> GENERATOR: Consolidated!Manifest Invoice: p;42 <br /> t. <br /> Site EPA ID#: <br /> Shipment Date <br /> Contact Person: <br /> Name: Driver Signature(Printed): <br /> Address:. `3 <br /> ,1 Truck# <br /> C <br /> City,Slate,Zlp� <br /> PO# <br /> Site Phone: r_ <br /> Product Waste CAManifest#0 Quantity units Price Amount <br /> Coda <br /> Non-RCRA Hazardous Waste Liquki(Used Oil):Lubilmling 221 4�e f ��. ► Gni <br /> Non-RCRA Hazardous Waste Liquid(Used 011):Industrial 221 Gal J <br /> Non RCRA Hazardous Waste L'puid(Used Automotive Antifreeze) 134 Gar <br /> Non•RCRA Hazardous Waste Lf uld(Oil&Water) 221 Gat <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used 01 223 Drums) <br /> Drained Used Oil FilterDnrm(s) Dntms) <br /> Empty Drum(s) Each <br /> Transportation&Truck Time NR. <br /> Hazardous Test <br /> Unless otherwise specified on(his Consolidated Manifest Receipt(invoice)Terms:Accounts duo on tho 10th of 0a month folroMng month of purchase. Past due r , <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1l1%par month,which is the ANNUAL PERCENTAGE RATE of to%. <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 /> Genetator 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-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. itis lawful to send used oil to out of state�=­�M� mpiy only wit the,�edera(used oil management stan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry Driver gnature r1 <br /> Signature of Generator,Representative or Agent of Generator: X :r <br />( Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr, <br /> 101 Hagen DNve <br /> Valley Springs,CA 95252 Woodville,WI 64028 Rama: <br /> 209.764.4600 71ti 5983363 <br /> CALOOD214411 WIROD0029751 Address: <br /> Recycling l <br /> &Disposal <br /> City,State,Zlp: <br /> Facilities <br /> Riverbank Off Transfer 5300 • Ramos Environmental <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Plano: <br /> 209-863-8181 916371-6747 <br /> CAL0000190817 CAUG04003666 EPA to: <br />