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• RECEIVED <br /> Mailing:P.O.Box 176,Salida,CA 95368 <br /> fi^ , 4612 Kieman Court,Salida,CA 95368 AUG 2 4 2015 <br /> Phone:2095454791 FAX 209.545-2241 <br /> George W. Lowry, Inc. EPA#CAR000047019 <br /> Environmental Services Division E WRONMENTAL HEALTH <br /> CA Transporter Number 3844 PERMIT/SERVICES <br /> CA License#768518 <br /> GENERATOR: Consolidated Manifest Invoice: N o 23964 <br /> Site EPA ID#: L11� �3�� - Shipment Date: 7), <br /> Contact Person: <br /> Driver Signature(Printed): �` <br /> ! - <br /> Name: -Ili+, i f I i� <br /> Address: <br /> Truck# <br /> City,State,Zip: "ti ��/ {�� PO# <br /> Site Phone: <br /> Product <br /> T221 <br /> CA Manifest 00 Quantity units Price Amount <br /> Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):LubricatingNon-RCRA Hazardous Waste Lquid(Used Oil):Industrial <br /> Gal <br /> Gal <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 <br /> Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 <br /> grunt, <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 1 / rf v J,` Ya— 1 <br /> DnuMs) <br /> Drained Used Oil Fitter Drum(s) Each <br /> mpty Drum(s) <br /> HR <br /> Transportation&Truck Time <br /> Hazardous Test <br /> of <br /> Unless otherwise specified F this Consolidated CCHARalt the PERIODIC(Invoice) <br /> Terms per Accmonounts <br /> due which�s a loth of#* PERCENTAGE ENfollTAGE RATE of purchase. Past due To - <br /> accounts will be charged a <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 /> �f�L!/�l( j' s(Generator's siynatun:) <br /> Note: George W. Lowry, Inc. hereby advises the Generator that X ------ <br /> --------- <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. Caiifomia 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 oil management stan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry Driver Signature X — <br /> C OC <br /> Signature of Generator,Representative or Agent of Generator. X <br /> ® ---- <br /> Greenleaf Environmental CRt Recycling <br /> 3,474 Toyon Cr. 101 Hagen Drive Name: <br /> Valley Springs,CA 95252 Woodville,Wt 54028 <br /> 8-3363 <br /> 209-754-4600 715.69yY1Rt>0OO297029751 Address: <br /> Recycling CAL000214411 <br /> 8 Disposal ® �cin,,state.Zip: <br /> Facilities Riverbank Oil Transfer 5300 Ramos Environmental <br /> Claus Road 1515 S.River Road <br /> West Sacramento,CA 95691 I Phone: <br /> Riverbank,CA 96367 916-371-5747 <br /> 209863.8181 CADOW003656 EPA ID: <br /> CAL0000190817 <br />