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Mailing:P.O.Box 176,Salida,CA 95368 <br /> GC <br /> e+ , aa}}FF 4612 Kiernan Court,Salida,CA 95368 FEB 2016 <br /> i:• etSrge -OW �1V(lye Phone:209-545-0791 FAX 209-545-2241 <br /> ? ' Environmental Services Division 1 <br /> EPA#CAR000"'1019 <br /> HE:iTw nl^PAPT�lAGwrr <br /> rnry CA Transporter Number 3844 <br /> .r•' ENVIRONMENTAL <br /> CA License#758618 <br /> GENERATOR: Consolidated Manifest Invoice: « 214 <br /> Site EPA ID#:d,,rAZW _70ff <br /> Shipment Date: <br /> Contact Person:. <br /> Name: _W _. Driver Signature(Printed): <br /> Address: I �1 '� ^� a.\ � Truck# <br /> City,State,Zip: . PON <br /> Site Phone: ` <br /> Product waste CA Manifest#G Quantity units Price Amount <br /> Code <br /> -Non-RCRA Hazardous Waste Liquid(Used 017):Lubricating 221 Goa 4 <br /> Non-RCRA Hazardous waste Liquid(Used 04:industrial 221 Galt✓ <br /> Non RCRA Hazardous Waste Liquid(Used Automotive Antiireeze) 134 Gat <br /> NORACRA Hazardous Waste liquid(Oil&Water) 221 Gal <br /> Non•RCRA Hazardous Waste Solids Contaminated with Used Oil 223 urum(s) <br /> Drained Used Oil Fitter Drum(s) Dmmts) <br /> Empty Drums) Each <br /> Transportation&Truck Time HR. <br /> Hazardous Test <br /> Unless Otherwise specified onthis consolidated WNW Receipt(invoibe)TermW Acus ave on the 10th of tri®moeOr foeowing marM cf purchase. Past due gqI <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 142%per month,which to the ANNUAL PERCENTAGE-RATE of 15%. r ..� <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 /> 1- <br /> Note: George W.Lowry,Inc.hereby advises the Generator that X 's(Generator's signature) <br /> shipment of used o1 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•morestnngent requirements,and some out-of-state fadGtles that profess 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. 11-owry Driver Signatu� <br /> Signature of Generator,Representative or gent ofOerierator: ,X I <br /> I riv f <br /> ILIA Li <br /> Greenleaf Environmental CRi Recycling <br /> 3474 Toyon Cr. 101 Hagen Drive <br /> Valley Springs,CA 95252 Woodville,WI 54028 ►tom: <br /> 209-764.46W 715-6983363 <br /> CAL00�14.4 WIROOOD29751 Add,,,,, <br /> R@CyCllns �v{}}f/ � • <br /> , &Disposal <br /> FBCiiit[eS Riverbank Oil Transfer 5300 Ramos Environmental City,state,zip' <br /> Claus Road 1515 S.RIVer Road <br /> Riverbank,CA 96367 West Sacramento,CA 95691 ' Phone. <br /> 209863.8181 9163716747 <br /> CAL110g019081T CAD004003556 EPA V. <br />