Laserfiche WebLink
CID <br /> 0 6376 <br /> THERMO FLUIDS- Truck#: <br /> ��» JUN 19 2015 Truck Gross Wt: <br /> The Responsible Solution Tare Wt: <br /> ENVIRONMENTAtt Service Date <br /> Truck Net Wt: <br /> t4aplTW r\Cp9DTAACKIT <br /> CUST LOC# ��� /'�'�' <br /> Customer/Generator Transporter Check <br /> Receiving Facility <br /> Thermo Fluids Inc Thermo Fluids Inc <br /> Name It ,,�� 4301 W Jefferson Phoenix,AZ 85043 AZR000003681 <br /> 910 E 4th St <br /> Address,City,State Zip Thermo Fluids Inc <br /> Santa Ana,CA 92701 4000 Arcata Las Vegas,NV 89030 NVR000001925 <br /> L , , 714-731-5995 Filter Recycling <br /> CAL000381082 180 W.Monte Avenue Rialto,CA 92376 CAD982444481 <br /> " rt US DOT#:641752 000 N Alameda St. Compton,CA 90222 CAT0800013352 <br /> EPA ID# FEDERAL TAX ID:59-3210374 Crosby and Overton <br /> Q� Y) 1610 W.17th St.Long Beach,CA 90813 CAD028409019 <br /> CA182640/HW Transporter 3871 Southwest Processors Inc <br /> Generator Phone 2 _ � 4120 Bandini Blvd Vernon,CA CAL921646037 <br /> Manifest � t DK Dixon <br /> Number(,)+)i I ZG�, 7300 Chevron Way Dixon,CA 95620 CAT800012602 <br /> Remit to: Field Test Result Test Type <br /> Thermo Fluids Inc Method of Payment Check# <br /> MSC#285 <br /> PO Box 29048 CASH CREDIT CARD TERMS PO# ppm Q-4000 Hydrochlor <br /> Phoenix,AZ 85038 <br /> DEL PLI HM Proper Shipping Description Tank Size Tank# #of Co yP ner TotaIQTY Unit of price Total <br /> Containers Type Measure <br /> { Non-RCRA Hazardous Waste Liquid,Used Oil-CA 221 <br /> d Non-Regulated Material,Used Oil Filters for Recycling <br /> Non-RCRA Hazardous Waste Liquid,Spent Antifreeze-CA 134 <br /> Non-RCRA Hazardous Waste Liquid,Brake Fluid-CA 343 <br /> Non-Regulated Material,Brake Lathe Grindings for Recycling <br /> Non-Regulated Waste,Spent Aqueous Parts Cleaning Solvent-CA 133 <br /> Non-RCRA Regulated Hazardous Waste Solid,Absorbents - CA 352 <br /> Non-RCRA Regulated Hazardous Waste Liquid,Oily Water - CA 223 <br /> Drums,NOI(Empty) <br /> Non-Regulated Liquid,New Antifreeze <br /> Circle one HD Premix HD Long Life Concentrate <br /> RQ,UN3082,Environmentally Hazardous Substance,Liquid n.o.s. <br /> x (Ethylene Glycol),9,PGIII ERG 171(New Antifreeze) <br /> Circle one HD Premix HD Long Life Concentrate <br /> Fuel Charge <br /> *For Terms and Conditions please go to:http://Www.thermofluids.comlbol T&C Fuel Charge Tax Rate % <br /> Sales Tax % <br /> Thermo Fluids Inc.hereby advises the GENERATOR that your shipment of used oil may be transported to a facility that is required to comply with federal regulations <br /> applicable to management of used oil,but that is not required to comply wih the more stringent requirements applicable to hazardous waste management facilities. <br /> California facilities that handle or process used oil are required to meet those more stringent requirements,and some out-of-state facilities that process used oil <br /> also meet those requirements.These include more stringent leak detection and prevention requirements,engineering certifications of tank integrity,and financial <br /> assurances for closure and accidental releases.It is lawful to send used oil to out-of-state facilities that comply only with federal used oil management standards <br /> and not these more stringent requirements. TOTAL <br /> Generator Certifies a program is in place to reduce the volume,quantity and toxicity of the hazardous waste to a degree determined by Generator to be practical. <br /> This is to certify that the above-named materials are properly classified,described,packaged,marked and labeled,and are in proper condition for transportation <br /> according to the applicable regulations of the Department of Transportation. <br /> Generator Name Transporter Name Receiver Name <br /> - r <br /> Generator Signature r Transporter Signature j: Receiver Signature <br /> €: I . <br /> Date <br /> Date Date <br /> In Case of Emergency cor`act CHEMTREC and identify Thermo Fluids as contract holder 800-424-9300 <br /> TF1 Office Use Only Al [� - <br /> BT BO YD T J. `r L DT� O "/"°-L or B YA EO ET <br /> S SO S SO S SO__ S SO S SO <br />