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Mailing:F.C.Boi-17C,SaIIOL,Ct.95361' <br /> 461.11 <br /> nIcG:e2mosadn,4Ct:o0u7no:SernAd;&.,2Cots.-95543:.6.0 <br /> Genul'Services 2 <br /> e•: <br /> Division k EPA 9 CAR000114701U <br /> sari. CA'Licens Transporter <br /> V76851B 3044 . ®�� <br /> CA License8750510 <br /> GENERATOR: Consolidated Manifest invoice: <br /> Site EPA ID#: <br /> Shipment Date: -- <br /> ContactPerson: <br /> ' Driver Signature(Printed) - - -•-"_„_-._.+. <br /> Name .,,• rf4' I,'. fir <br /> Address: I-Z ” "-� ' t TnjcI:# <br /> City,.State,21p: ,.r• -. ;YO'a . <br /> Site Phone: <br /> 'Product 'waste 'CA Menifestf0 Quantity Units Price Amount <br /> Code <br /> `Non-RCRA.HazardousWasle L'qpuld(Used Oi :Lubricating 221 E^ } �. ! Gal - 1 <br /> Nan-RCRA Hazardous-Waste.Lquid.(Used Oil):Industrial 221 : Gal <br /> J <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> _......_..,. rr ... <br /> .' on-RCRA Hazardous Waste.Liquid(Oil&Water) .221 "1- ! �' +^"-y Gal <br /> i J <br /> Non-RCRA Hazardous:Waste Solids Contaminated withUsed Oil -223 . <br /> Drained Used.Oil Fitter.Drum(s) - -Drumis) <br /> Each <br /> MR. <br /> Transportation'&Truck Time - <br /> -Hazardous Test <br /> UnlessothervmspecifiedonthisconwiGted'Mandell-Receipt(In.m)Terms: Accounle'tlue onihe lmh orMe month followiria nwmh of purdiase. Pasldue Total <br /> accounts sin be chomed a FINANCE CHARGE:aI the PERIODIC RATE&1412%per monM,which is the ANNUAL PERCENTAGE RATE or 18%. p <br /> By signingthis receipt,.the Generator certifies that program has been established to reduce the volume or quantity andtoxicity of the hazardous waste to a degree as <br /> determined bythe generator,.to be economically practicable. <br /> Generator certifies that all Hazardous Waste listed on this Consolidated:ManifestReeeipt is profiled to meet Waste Codes as listed'above. <br /> Note: George W. Lowry, Inc-hereby advises the'Generatolthat X 's(Generators'signature) <br /> shipment of used oil may be transported to a facility required to comply with federal regulations applicable to management of used oil.but that Is <br /> not requiredtocomply with the more stringent req uirements:applicable to hazardouswastemanagement facilities.-California facilities that handle or <br /> process.used oil are required to meet:those'more stringent requirements,and.some out-ofestate facilities that process used oil also meetthose 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 islawful tosend used oitto out of state facilities that comply only with the Federal used oil an3gement,s+„tan- <br /> dards'and,not these'more stringent requirements. - f ,'`'71 +- ✓+' <br /> This notification is for information only. Lowy Driver Signature X, <br /> Signature of Generator,Representative or Agent of Generator: K <br /> AJS Filter Processing,Inc. ®ecycling <br /> 15131 E.Clark Avenue,Bldg.E 101 Hagen Drive Nacos: <br /> Industry,CA 91745 Woodville,1M 54020 <br /> 626.3335677 i 1 7A5699-3363 <br /> yWIR000029751Atltlre ss: <br /> Recycling cALoo 097432rf J ' <br /> 8 Disposal f % l Y4 �'� ® City.Sims,Zip: <br /> Facilities +Riverbanl:91lTronsfer 5300 Ramos Environmental <br /> J' i 1515 S.River Road <br /> _ : 'Claus Roatl <br /> Riverbank;CA.96367 I Wast Sacramento,CA 95691 Phane: <br /> ?rW-9n1-91R1 916-171-5747 <br /> CA,!.a^nn,onn„ CAnftrAN355F -. <br />