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10/19/2004 12:46 <br />2094664 <br />Georne W. Lowry, Inc. <br />Environmental Services Division i <br />t:. <br />GENg,_ TOR: <br />Site EPA 1D#: � �' <br />= �,: <br />Contact Person: <br />Name: <br />Address: <br />City, State, Zip: <br />Site Phone: <br />GARY WHELIHAN 9 <br />Mailing: P.O, Box 176, Salida, CA 95368 <br />4612 Kiernan Court, Salida, CA 95368 <br />Phone: 209.545.0791 FAX 209.545-2241 <br />EPA # CAR000047019 <br />CA Transporter Number 3844 <br />CA License 9 758518 <br />PAGE 01 <br />Consolidated Manifest Receipt: 11736 <br />Shipment Date: <br />Driver Signature:' :;°°"` c✓ <br />,� <br />Truck # -� <br />Product <br />Waste Manifest quantity <br />Coda <br />Units <br />Price Amount <br />Non-RCRA Hazardous Waste Liquid (Used Oil) :Lubricating <br />221 <br />GAL <br />t " <br />Non-RCRA Hazardous Waste Liquid (Used 011):Industrial <br />221 <br />GAL <br />Non•RCRA Hazardous Waste Liquid (Used Automotive Antifreeze) <br />135 <br />GAL <br />•- <br />Non-RCRA Hazardous Waste Liquid (Oil & Water) <br />221 <br />GAL <br />Non-RCRA Hazardous Waste Solids Contaminated with Used oil <br />111, 11 <br />Drained Used oil Filters <br />221 <br />Now= <br />GAL <br />Drum(s) <br />Waste Solids & Sludge <br />Wash Out <br />Empty Drums <br />EA. <br />Transportation & Truck Time <br />HR. <br />Hazardous Test <br />Unicj5 otherwise specified on this Consolidated Manitesi Receipt (Invoice) Terms: 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 1-1/2% per month, which is the annual PERCENTAGE RATE of 16% <br />Total 1 <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 <br />a degree as determined by the generator, to be economically practicable. <br />Generator certifies that all Hazardous Waste listed on this Consolidated Manifest Receipt is profiled,W7 eel the waste Codes as listed above. <br />Signature of Generator, Representative or Agent of Generator: x w' ... <br />Recycling & Disposal Facilities <br />Greenleaf Environmental <br />3474 Toyon Cr. <br />Valley Springs, CA 95252 <br />209-754-4600 <br />CAL000214411 <br />Riverbank Oil Transfer <br />5300 Claus Road <br />Riverbank, CA 95367 <br />209863-8181 <br />CAL000190816 <br />Americlean <br />2430 Almond Dr. <br />Silver Springs, NV 89429 <br />775-577-9001 <br />NVO082358483 <br />load <br />CRI Recycling Service, Inc. <br />101 Hagan Drive <br />Woodville, WI 54028 <br />715-698-3363 <br />WIR000029751 <br />Name:�'�`�a <br />Address <br />City, State, Zip:..,,,,, i Vit. y <br />Phone: <br />EPA ID: <br />