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s v•� <br /> RECEIVED <br /> Mailing:P.O.Box 176,Salida,CA 95368 <br /> ' rn 4612 Kiernan Court,Salida,CA 95368FEB2016 <br /> George W. Lowry, Inc. 41 ~r Phone:209645.0791 FAX 209-60-2241 <br /> Environmental Services Division -j EPA#CAR000047019 <br /> ===14 CA Transporter Number 3844HEAI H F?FPARTYFKIT <br /> CA License#758618 <br /> GENERATOR: Consolidated Manifest Invoice: <br /> Site EPA Shipment Date: <br /> Contact Person: YLA ) J <br /> Name: (f ® J Driver Signature(Printed): <br /> Address: Truck# r!1 .✓� <br /> City,State,Zip: 4� <br /> PO# <br /> Sitg Phone: <br /> Product waste CA Manifest 40 Quantity units Pike Amount <br /> Code <br /> Non-RCRA Hazardous Wasta Liquid(Used 011):Lubricating 221 /�7 f� A�Q Get <br /> Non-RCRA Hazardous Waste Liquid(Used C111):Industrial 221 f 27 f Get <br /> Non RCRA Hazardous Waste Liquid(Used Automotive AneTreeze) 134 <br /> Non-RCRA Hazardous Waste Liquid(011&Water) 221 r.ar <br /> Non-RCRA Hazardous Waste Solids Contaminated with Used Oil 223 Daunts) <br /> rained Used Oil Fitter Drum(s) <br /> Empty Drum(s) 'Each <br /> Transportation&Tnick Time RR. <br /> Hazardous Test <br /> Unless oererMse speaYied on fids Consolidated Manifest Receipt(invoice)Tenm Accounts due on the 10th or the monhh!crowing month OfPwchasa. Past due Total <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE or 1-12%per month,which is the ANNUAL PERCENTAGE RATE of 18%. e <br /> By signing this remipt,the Generator oartifies that a program has been established to reduce the volume or quantity and toidcity of the hazardous waste a degree <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 Codas as listed above. <br /> Note:George W.Lowry,Inc,hereby advises the Generator that X 's(Generator'ssignature) <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 ori 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 sta - <br /> dards and not these more stringent requirements. ' g <br /> This notification Is for information only. Lowry Driver Signjtt X ( j <br /> Signature of Generator,Representative or Agent of Generator: X13 <br /> l t + <br /> (t <br /> Greenleaf Environmental CRI Recycling ,t <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,Wi 54028 Name. <br /> 209-7644600 715.6983363 <br /> CAL000214411 WIR000O29751 Address: <br /> Recycling . <br /> &Disposal , Ci <br /> Pacili6es Rlve raa''n"'kk Olt ransfer 5300 Ramos Environmental off'State.2tP• <br /> Claus Road 1615 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209863.8181 916371-5747 <br /> CAL0000190817 CA00040O35M EPA 10: <br />