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AV � 378- Y <br /> ' Mailing:P.O.Boz 176,Salida,CA 95368' 1 - <br /> 4612 Kiernan Court,Salida,CA 95366 <br /> >> George W. Lowry, Inc. Phone:209545-0791 FAX 209-545-22&EB 2 4 2015 <br /> Environmental Services Division EPA#CARGOt1047019 <br /> r _. _. ut' <br /> .:CA Transporter Number 3844 B�,CI�j V,R®N MiNTAt. <br /> CA License#758518 B'T"-" Con n+npr,,iT <br /> GENERATOR: Consolidated Manifest Invoice: _<n 26029 <br /> Site EPA ID#: J 00U3 ,�_9- 7.7 ." . <br /> Shipment Date: ter//'_ 7 <br /> Contact Person: t% / <br /> Driver Signature(Printed): / <br /> Name: A— (,i ^,,,.fol:tt-! ) i.,• j -r,.:rY <br /> Address: ? I c...ri�<!T5 .J'i;f1 r,* Truck# <br /> M: <br /> City,slate,Zip: -$L,,. fl(•�.n <br /> PO# <br /> Site Phone: <br /> Product waste CA Manifest#0 Quantity Units price Amount <br /> Code <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Lubricabng 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Industrial 221 Gal <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifieeze) 134 cal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 221 cal <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used 011 223 Orum(s) <br /> Drained Used Oil Fitter Drum(s) rxun4al <br /> Empty Dmm(s) Each <br /> Transportation&Truck Tune HR. <br /> Hazardous Test <br /> Unless olhemw spevned m this Consoli"e Manliest Receipt(Invoice)Terms:Accounts due m Ne 10N of the month following month of purchase. Past due Total <br /> aaomts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-IU%permonth,which is the ANNUAL PERCENTAGE RATE of 18%. �?r <br /> By signing this receipt,the Generator certifies that a program has been established to reduce the volume or quantity and tomaty of the hazardous waste to a degree as <br /> determined by the generator,to be economically practicable. <br /> Generator cerlifies 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 hazardous 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 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 f,.tJf'1 <br /> Signature of Generator,Representative or Agent of Generator: X <br /> Greenleaf Environmental CRI Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,WI 54028 <br /> 209-7544600 715-698-3363 <br /> CAL000214411 MR000029751 Address: <br /> Recycling <br /> &Disposal 0 Q Cay,SbM,Zip: <br /> Facilities Riverbank Oil Transfer 5300 Ramos Environmental <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Pham: <br /> 209-8633181 9163715747 <br /> CALOD00190817 CAD004D03656 EPA ID: <br />