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"""'RECEIVE[ <br /> M Malting:P.O.Box 176,Salida,CA 95366 <br /> 4612 Kleman Court,Salida,CA 95368 FEB 17 2016 <br /> GeOrl WLOWry, Inc. # Phone:209-6454701 FAX 209-545-2241 <br /> Env�iro mental services Division EPA#CAR000047019 <br /> ENVIRONMENTAL <br /> rte-- <br /> CA Transporter Number 3844HEALTH <br /> DFPARTMENT <br /> lakere <br /> Z' CA License#758518 <br /> GENERATOR: Consolidated Manifest invoice: c: <br /> 26193 <br /> Site EPA ID# °�' <br /> Shipment Date. <br /> Contact Petsort: <br /> Name: Driver Signature(Printed): <br /> Address: fr�t EPo# <br /> 0 <br /> City,State,Zlp: �► i Fs C. r• r <br /> Site Phone. <br /> Product waste CAManifest#0 Quantity units price Amount <br /> Code <br /> on-RCRA Hazardous Waste Liquid(Used 011):Lubricating 221 i�+, ,�f f Gal e,t� <br /> Non-RCRA Hazardous Waste Liquid(Used Oil):Industrial 221 Gal <br /> Nal RCRA Hazardous Waste Liquid(Used Automotive Ari eeze) 134 Gal <br /> Non-RCRA Hazardous Waste 1.4uld(Oil&Water) 221 Gat <br /> Non-RCRA Hazardous Waste Solids Contaminaled with Used Oil 223 Drums) <br /> Drained Used Oil III RerDIII m(s) ®rungs) <br /> Empty Drum(s) Each <br /> Transportation&Truck Time pR <br /> Hazardous Test <br /> Unless otherwise Sped88d on Otis Con <br /> solldated Manifest Receipt(invoice)Tam:Aommis due on the 10th or Ste mn8r falrowbV mtonth of purchase. Past due To <br /> a000emts win be drarped a FINANCE CHARGE at the PERIODIC RATE of 1-112%per month,which is the ANNUAL PERCENTAGE RATE of 18%. <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 /> Genetator 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. California facilities that handle or <br /> Process used oil are required to meet those more stringent requirements,and some out-o&state facilities that process used oil also meet those require- <br /> ments These include more stringent leak detection and prevention requirements,en ineed certifications of tank in <br /> [egufEj,and financial assurances <br /> forclosure and accidental releases. itis lawful to send used oil to out of state thatply my o stan- <br /> dards the�ederal used oil management Stan <br /> dards and not these more stringent requirements. <br /> This notification is for information only. LowryDrivertgnature <br /> l t <br /> Signature of Generator,Representative or Agent of Generator: X <br /> D/ <br /> i ? <br /> Greenleaf Environmental CRi Recycling i <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,WI$4028 Nazno <br /> 209-7544600 716.6983363 <br /> Recycling CALOOD214411 WIRQOD029751� Address.- <br /> City, <br /> ddress:City,state,zip: <br /> Facilities <br /> R[verban <br /> k Oil Transfer 5300 dramas Environmental <br /> Claus Road 1515 S.River Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 Phone: <br /> 209-8638181 916371-&47 <br /> CAL0000190817 CADOD4003556 EPAID: <br />