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glr.(• Mailing:P.O.Box 176,Salida,CA 95368 <br /> 4612 Kiernan Court,Salida,CA 95368 <br /> ^>George W. Lowry, Inc. ` Phone;209-94S4791 FAX 209.5454241 <br /> Environmental Services Division r:� EPA#CAR000047019 <br /> i --4- = `t CA Transporter Number 3B44 <br /> CA Ltcense#758518 <br /> GENERATOR: Consolidated Manifest Invoice: <br /> 0i_,r 25403 <br /> Site EPA IQ#: �� � ` �: <br /> Shipment Date: _/;L,/- <br /> Contact Person: <br /> Name: Driver Signature(Printed): <br /> rl� <br /> Address: f '` Truck# <br /> City,State,Zip: jl PO# <br /> Site Phone: <br /> Product waste CAManifest#0 Quantity units Price Amount <br /> Code <br /> Wan•RCRA Hazardous Waste Liquid(Used 011):Lubricating221 <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):industrial 221 C Gat <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gat <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 Gal <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 223 Drum(s) <br /> Drained Used Oil Filter Drum(s) 13runh(s) <br /> i <br /> / Empty Drums) Each <br /> Transportation&TruckTime " HR. <br /> Hazardous Test <br /> `".a <br /> Unless otherwise specified on[He Consolidated Manifest Receipt(Invoice)Terms:Accounts due on the 10th 0 the month(allowing month or purchaso. Past due Total <br /> accounts will ba charged a FINANCE CHARGE al the PERIODIC RATE oil-M2%per month,which is the ANNUAL PERCENTAGE RATE of 18%. ,e erf <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 hazarddus 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 facil��that comply only with the Federal used oil manaltement Stan- <br /> dards and not these more stringent requirements. , <br /> This notification is for information only. Lowry Driver Signature <br /> Signature of Generator,Representative or Agent of Generator: ' X /,-Pl/,11 <br /> ® 13 <br /> Greenleaf Environmental CRi Recycling <br /> 3474 Toyon Cr. 10i Hagen t)rl,10 <br /> Valley Springs,CA 85252 Woodville,Wl 540 8 Nemo <br /> 209-764.4600 716-698.3363 <br /> CAL00021 'I WiR00D029751 Address: <br /> Recyc)ing <br /> &Disposal (+ <br /> 1=acilitie5 R)irerbank Oil Transfer 5300 Ramos Environmental cur,State,zrp: <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209-863.8181 916-371.5747 <br /> CAL0000190817 CAt)004003656 EPA ID: <br />