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RECEIVEL <br /> Mailing:P.O.Box 176,Salida,CA 95368 <br /> FEB 2016 <br /> 4612 Kiernan Court,Salida,CA 95368 <br /> ` <br /> George W. Lowry, Inc. Phone:209.6460791 FAX209S45-22 - <br /> EnvironENVIRONMENTAL <br /> mental Services Division f:{ EPA#CAR000047019 <br /> 1 ,....._._.,._. .,.. . 11FO4RT�Xkrr <br /> CA Transporter Number 3844 HEAKTH <br /> CA License#758518 <br /> GENERATOR: <br /> ID QR: <br /> Sitee EPA ID Consolidated Manifest Invoice: :{sy 24804 <br /> �i� � �"� �.+`r <br /> Contact Person: !�C <br /> Shipment Date: A )�r t;J -7 <br /> `t <br /> NameKQY2j0 QA Driver Signature(Printed): �� �} <br /> Address: �-'f✓JG'�1 <br /> t�0 /7 triv� Truck# <br /> City,State,zip:, <br /> Sit#Phone: P®# <br /> Product Waste CA Manifest#0 Quantity units prime Amount <br /> Code i <br /> -Non-RCRA Hazardous Waste Liquid(Used Oil):Lubrigting 221 6 01/34'r-VI <br /> +S I 3 v Gal 6 <br /> Non-RCRA Hazardous Waste Liquid(Used 011):Industrial 221 l:! i Got <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 134 Gal <br /> Non-RCRA Hazardous Waste Liquid(00&Water) 221 Gat <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used 01 223 Drum(a) <br /> Drained Used 011 Filter Dium(s) <br /> Emply Dwm(s) Each •�7 <br /> Transportation&Truck The NR <br /> Hazardous Test <br /> Unless otherwise spedded of this Consandeted Prhartifad Receipt(invoice)Terns:Accounts due on the 10th of the month following month of ptsaham Past due YOta <br /> acoormtS will be charged a FINANCE CHARGE at the PERIODIC RATE of 141146 per month,which is the ANNUAL PERCENTAGE RATE of 18%. <br /> -f 11p <br /> By signing this receipt,the Generator certifies that a program has been established to reduce the volume or quantity and to>ardty of the hazardous waste to <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 re4uirements applicable to hazardous waste management facilities. Califomia facilities that handle or <br /> process used oil are required to meat those more stringent requirements,and sorne o -state fadifttes that process used oil also meet those require- <br /> ments These include more stringent teak 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 statectiibm"at-conlpl only with the F erallused oil management stan- <br /> dards and not these more stringent requirements. <br /> This notification is for information only. Lowry Driver,SI tlafu�rp E <br /> Signature of of Generator,Representative or Agent of Generator: <br /> Greenleaf Environmental "C11 Recycling <br /> 3474 7oyon Cr. illi Hagen Drive <br /> Valley Springs,CA 95252 Woodville,Wl 54028 Name= <br /> 209-7544600 7156983363 <br /> CALOOD214411 WIR000029751 Address: <br /> Recycling , .� <br /> &Disposal ��'" t-•" <br /> FaCititJ@S Riverbank Oil Transfer 6300 Ramos Environmental C6Y.State,ZIP: <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 west Sacramento,CA 96691 Phone: <br /> 209563.8181 9163715747 <br /> CALOODDISO817 CA000400306 EPA ID• <br />