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• • REGEIVED` <br /> s Mailing:P.O..Box 176,Salida,CA 96368 FEB 2 4 2015 <br /> 4612 Kiernan Court,Salida,CA 95368 A� 1 <br /> George W. LOWry, Inc. _ <br /> Phone:209s45-07s1 FAX 209�tV IRONMENTAI. <br /> I' Environmental'Services Division EPA#CAROODD47019 SIV VIfi <br /> �-I�CpQI]TA1CAlT <br /> CA Transporter Number 3844 <br /> CA License#758518 _ <br /> GENERATOR: Consolidated Manifestlnvoice: .rt °a+ <br /> Site EPA ID#: .:. �H-L..Lit".11..J �'Gr Sf'-icor' J <br /> - Shipment Date: <br /> Contact Person: <br /> Name: � Driver Signature(Printed): <br /> pp <br /> L.r :�; <br /> Address: Ss'_'s .� _Jz"&4 >1" '� Truck# <br /> �,. , - <br /> City,State,Zip: ,"'�'{ruv-li �((is�t PO# <br /> Site Phone: <br /> Product Waste CA Manifest#0 -Quantity Univ. Price Amount <br /> Code <br /> Non-RCRAHazardous Waste Liquid.(Used:Oil):Lubncating 221 - - <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Industrial. 221 _- _. Gar <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 eat <br /> Non-RC I RA Hazardous Waste Liquid(Oil&Water) - 221 Gal - <br /> Non-RCRA Hazardous Waste Solids Contaminated With Used Oil 223 Driunt.)- - <br /> '.Dmined Used Oil FilerOmm(s).. Dn'n'(al- <br /> �EmptyDrum(s). <br /> mnsportation$Tmdc Time ( 413-L,261 <br /> t '1y/ HR <br /> . HBi.�rdQn Test �'✓..(. �t' r • lit:'-l.7`G'ti L1 - e261 nAz ;7' tr..rt _ - •1;:. <br /> _ �i / a <br /> Unless otherwise specified on Ohs Consolidated Manifest Receipt(Invoice)Teans Accounts due on the foth of the month foiloving nooth Of purchase Past due Total <br /> accounts vnll be charged a FINANCE CHANCE at the PERIODIC RATEof 1-12%permonth,which is the ANNUAL PERCENFAGE RATE of 15% <br /> By signing,this receipt the Generator certifies that a program has been established to reduce the volume or quantity and toxicity of thei hazardous waste to a degree as <br /> determined.by the generator.tobe economically practicable. - <br /> Generator certifies that all Hazardous.Waste listed on this Consolidated Manifest Receipt is profiled to meet Waste Codes as hsteil.above: <br /> eNote: George W. Lowry, IDC..hereby advises the Generator that X 's(Generator's signature) <br /> shipment of used oil maybe 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 withthe more stringent requirements applicable to hazardous waste management facilities. California fadldiesthat handle or <br /> -process used:oil are required to meet those more stringent requirements,and some out-of-state facilities that process used of also meet those.reguire- <br /> meets These include more'stringent leak detection and preventionrequirements;engineering certifications of tank integrity,and financial assurances <br /> forrclosure 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 - ,.-^ j <br /> This notification is for.infonnatiomonly- Lowry Driver Signature X i <br /> Signature of Generator,Representative or Agent of Generator: X •'� i�,,,`r^ ' �• '`(` f <br /> Greenleaf.Environmental - CRI Recycling: <br /> 3474 Toyon Cr 10+Hagen Drive <br /> Valley Springs,CA 95252 Woodville,W154020 Namo: <br /> 209-754.4600 715498J363 <br /> . .. CALOOD214411 VAROOD029751.. . . - Address:.. <br /> erycling <br /> Disposal ® ® ' Cdy,State,2lp: <br /> FaCllitles Riverbank Oil Transfer 5300 Ramos Environments] - <br /> Claus Road. 1515'S.River Road <br /> Riverbank,CA 96367 - West Sacramento;CA 95691 Phone:' <br /> 209-863-8781 - 916-ZI 5747 <br /> CAL0000190817 'CAD004G035M - EPAID:- <br />