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George W. Lowry, Inc. <br />Environmental Services Division <br />GENERATOR: <br />Site EPA ID #: <br />Contact Person: <br />Address: <br />City, State, Zip: <br />Site Phone: <br />Mailing: P.O. Box 176, Salida, CA 95368 <br />4612 Kiernan Court, Salida, CA 95368 <br />Phone: 209545-0791 FAX 209-545-2241 <br />EPA # CARD00047019 <br />CA Transporter Number 3844 <br />CA License # 758518 <br />Consolidated"Manifest Invoice: ! -� � '3 <br />c_.. „: <br />Shipment Date: <br />Driver Signature (Printed): <br />Truck # <br />PO # <br />Product <br />Waste <br />Code <br />CA Manifest #0 Quantity <br />Units <br />Price <br />Amount <br />Nort=RCRA-HazardousWastetiquk (Used-Olt)--Wbhtatirig– <br />221 <br />– --- - _ ._ --- <br />�ar- <br />RA Hazardous Waste Liquid (Used Oil) : Industrial <br />221 <br />© ` <br />Gal <br />RA Hazardous Waste Liquid (Used Automotive Antifreeze) <br />Pon <br />134 <br />Gal <br />RA Hazardous Waste Liquid (Oil & Water) <br />221 <br />91f,011 `Gal <br />RA Hazardous Waste Solids Contaminated with Used Oil <br />223 <br />Drums) <br />Drained Used Oil Filter Drum(s) <br />Drums) <br />Empty Drum(s) <br />Each <br />rtation & Truck Time <br />HR. <br />�J <br />us Test <br />Unless otherwise specified on this Consolidated Manifest Receipt (Invoice) Terns: Accounts due on the 10th of the month following month of purchase. Past due <br />accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-12% per month, which is the ANNUAL PERCENTAGE RATE of 18%. <br />Total <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 />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. Califomia-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 manag�jtnent stan- <br />dards and not these more stringent requirements. A /„ '/ <br />This notification is for information only. Lowry Driver Signature X <br />Signature of Generator, Representative or Agent of Generator <br />11,2, / / -16 - / L <br />0 <br />AJS Filter Processing, Inc. CRI Recycling <br />15131 E. Clark Avenue, Bldg. E 101 Hagen Drive <br />In ustry, CA 91745 Woodville, WI 54028 <br />6 - 33-5617 WIR0000297 <br />_C 097432 WIR000029751 <br />Recycling <br />& Disposal r0 <br />Facilities RI rbank II T nsf9l� Ramos Environmental <br />CI s Road 1515 S. River Road <br />erbank, CA 96367 West Sacramento, CA 95691 <br />9.863-8181 916371-5747 <br />CAL0000190817 CAD004003556 <br />Name: <br />Address: <br />City, state, zip: <br />Prone: <br />EPA ID: <br />