|
Malti P.O.Box 176,Salida.CA 95368
<br /> 461210aman Court.Saslda,CA 95368
<br /> Mailing:P.O.Box 176,Safida,CA 95368
<br /> 46,2 Woman Court.SalkW,CA 95368 George W.Lowry,Inc. Phoruc2095450791 FAX2°4-5°5.2241
<br /> 4612 WomanC Court,
<br /> FAX 209545.8 1 Environ mental SerA-.Division EPA 0 CAR0006t7019
<br /> George W.Lowry,Inc. CATranaponerNumber31144
<br /> EPA 3 CAR000047019
<br /> Environmental S-4—Dl.ulonCA License 3758518
<br /> } _ CA Transporter Number 3844 - ..
<br /> AM X
<br /> CA License 3758518 -
<br /> _ yy GENERATOR• consolidated xlattttest Invoice: N 2- 2 6 8 8 2
<br /> GENERATOR: Consolidated Manifest invoice: No 25552 Shipment Date. LZ— .
<br /> Site EPA ID#: _ Shipmeld Date: Contact Prom Driver Signature(Printer!).
<br /> Contact Person: •—_ Name:
<br /> Name:
<br /> Driver Signature,(Printed): Addma: Truck# `'Z
<br /> •^ •, ,..
<br /> Address: Truck 3 r - City,SfaM.Zip: PO 3
<br /> City,State,Zip: PON
<br /> ne: l Sat.Phone
<br /> Site Pho - - Wdta Price Amount
<br /> -....-.: wda CA ALattifeSt30 Quantity cod.
<br /> Wna CAt4anifes[30 Quantity ON. ...Prim Amain O Gal
<br /> Product I/ .c.� t - -Mm-RM Hazardous waste Liquid(Used M lArkafmg �1 D G Z{� 'Sr�
<br /> J D
<br /> al
<br /> rrRCRA Hazardous Waste Liquid(Used Of)d.ua
<br /> br cing 221 :.. (c w a S -._... p Na;-iCRA HazardousHazardousWaste Liquid(Used Oi) Gar
<br /> :bMustrial 221 W
<br /> Non-RCRA Hazardous Waste Liqud(Used�:Industrial 221 I' Gsl Non RCRA FIazardous Wass liquid(Used Aubrnoive Antlfleem) 134
<br /> on RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 i:%7 y Gar L. Nor-RCRA Hazardous Waste Liquid(0f S Waterl 223 ed
<br /> Nm-RCRA Hazardous Waste Liqud(06 S Wafer) 223 Gr Non•RCRA Hazardous Wass Solids Cmiammasd with Used Of 357 D—Ie)
<br /> is
<br /> Noo-RCRA Hazardous Waste Sol ds Contaminated with Used Oil 352 °n""I`) Drained Used 08 FdlerDnon(s) mt4q
<br /> Edi
<br /> Drained Used 08 Filler Darns) O-*) Ell"Drum(s)
<br /> Empty Drum(s) Eads Ttenspollation STludrTime NR
<br /> Transporlation 8 TmdcTime Hazardous,Test
<br /> Hazardous Test
<br /> . tldw olnm tochaodaanab CamARGEMe16ed RaoapttNwictI A®tNabnmW,,aAofanmERCWAGeRKlEdPad,mm.Pasttlue 7o1aI M.
<br /> '�� acrmaxa vM Iz dr.peda FmIWCE CRARGE arllo PHdODIC MTE d 1-t2X prnradt,vhidt'a IIr ANNUALP6LCENfAGE RATE d18X
<br /> t)dme oltnnw•a sped6ed ondb Caeddue4 Ydmi6nsL Roodµ(trnoice)Tome Aecaml0 .,thelMdemmmNtotlauinpmMddpaduso.Pend, Total ---.
<br /> acraunls W,A as oM1v9.ria FOUwCE CKARGE a,ete PERIODIC PATE er1-1r2%per month W.•+'wive ANNUAL PERCENTAGE RATE d 18X
<br /> By signing this receipt,the Generator certifies that a program has been established to reduce the voWme or quantity and tOddty of me hazardous waste 10 a degree as
<br /> detemdned by the generrto4 to be economically prac6=Wc.
<br /> Sy signurg This r.ceipt the Generator co if—that a pmgmm hasee
<br /> bn establistwo, —duce the volume or quantity and toxicity of the hazardous waste to a degme as Gemmtor cedifies that an Hazardous Waste listed on tills Consolidated MaNtest Receipt is profiled to meet Uta Waste Codes as fisted abo✓e.
<br /> determined try the generator,to be economically practicable.
<br /> Generator ceniftes that a8 Hazardous Waste fisted on this Consolidated Manifest k.-.apt is profiled to meet the Waste Codes as listed above.
<br /> Note:George W.Lowry,Inc.hereby advises the Generator thio C •s(Generator's signature)
<br /> Note-George W.Lowry,Inc.hereby advises the Generator that x 's(Gemmic is signature) shipment of used oil may be transported to a fadiity that is required to comply with federal reguhtrons appligble to management of used of but thaor
<br /> t s
<br /> shipment of used oil may be transported to a facility,that is required to con,rhly with federal regulations applicable to management of used oil but that is not required to comply 1 ith the more stringent requirements applicable to hazardous waste management tact process
<br /> ss sm®fa also
<br /> m that handle
<br /> require-
<br /> not required to comply with the more stringent requirements applicable to hazardous waste management facifties.California fatalities that handle or process used of are required to meet those more stringent requirements,and some outofstate facilities that process Iced oil also meet those aces
<br /> process used oil are required to meet those more stringent requirements._nd some out -state faaTdies that process used of also meet those require- ments These include more stringent leak detection and prevention requirements,engineering certifications of lank itrtegrity,and frnandal assurances
<br /> and financial assurances for closure and accidental releases.ft is lawful to send used of to out of state only,with the Federakused of management stan-
<br /> ments These include more stringent leak detection and prevention requirements,engineering car ifiwtions of tank integrity, dards and not these more stringent requirements.
<br /> for closure and accidental releases.R is lawful to send used of to out ofmh to faFi - Doty with used l 9.�nent stan-
<br /> dards and not these more stringent requirements. \\a This notfipdon is for infortnafion only. Lowry Driver
<br /> This notification is for information only. LawryDn—Signature
<br /> Signature of Generator,Representative or Age_of Generator. X �—
<br /> Signature of Generator,Representative or Agent of Generator: X-. -
<br /> �2- 7i6=0
<br /> ersOdd Trxosd r Ma^°Oomonl
<br /> E Brooding.Lam Vane Ave. Nom,•
<br /> Bak.mBeld Transfer Global Mata,,..Management i- S.M.A.ld,CA 93307 Hollywood,CA 91605
<br /> 1620EE•lmdago L:s:c 12bivama:..-. I del' 5238 818.900.8476
<br /> eakersfiafd,CA 93307 Hollywood,LA 91605 Nam°' CALOOD384844 A4enmc
<br /> •t CAL'=-.598
<br /> 6613224258 818-9005476 Recycling 7'�,
<br /> CAL000384e11 Add— &Disposal e t c.nsm.22a
<br /> Recycling L
<br /> &Disposal ® r.wets Zip: Facilities Riverbank 00 Transfer 5300 Ramos RivrRoad ai
<br /> Claw Road 16165.River Road Prm+c
<br /> Facilities Riverbank Oil Transfer 5300 Rations Envi.—mental Riverbank CA 96367 wast Sacramento.CA 95691
<br /> Chea Road 1515 S.Rl—Road 209-6635181 9163715747
<br /> Riverbank CA 96367 West Sacr:....nto,CA 95691 Phonx CALOW0190817 CAD0040036W EPA 10-
<br /> 209-8634101 91637157.,
<br /> CAL000019GS17 CAD004003- 6 ®A m: ,
<br /> REV.t2-1
<br /> REV.12-14
<br />
|