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WORK En*i tat Inc.. 2581 S. Sunland Ave. Fresno, CA 95725 Phone:, 8007531-9683 WASTE RECYCLING,R' �' PT Name: L C. -U^ -C.- V C Cwstomet Purchase Order #,. Service Teph{�ie'ian City, State, Zip: I� F�hone #: EPA ID 3 Federal`Manife8A #; QUANTITY UNITS U.S. DOT DESCRIPTION OHAPtQE' GAL USED OIL = NON PiCRA HAZARDOUS WASTE, LIQUID GA WANE"CODS &1 USED ANTI -FREEZE = NON RCRA HAZARDOUS WASTE, LIQUID GAL. CA WASTE CODE 134 © OILY WATER FROM USED,�ARTS WASH SOLUTION a NON-RCRA HAZARDOUS WASTE, LI`CQ GAL. UID. CA WASTE Ci7DE 184 WDRUMS) DRAINED USED OIL AND"GAS VILTERS m 0 TOTAL LU It `377 J The above used bil is % Lubricat n oil % Ir dustnal oil CL ACCOUNT STATUS: O C.O.D. (T OPEN ACCOUNT If open Account - payment hi due net 30 days or "a finance i l et e'otl 1'F5`O!e per month wlll apply, U GENERATOR'S NOTIFICATION AND CERTIFICAT ON: Any used oil that the transporter receives from the generator will be transported to a cerufied used oil r@cyehng fadill- W ty that is lawfully operating in accordance "with a hazardous waste facilities'permit issued pursuant to the Fed#ral Act. I hereby declare thatthe conte618 of%thi3� k) n Ca ment•are: fully and accurately described pbovo by the proper shipping,name and are Classified, packaged; marked, and labeleq;pnd are In -)all ;espgcts m,proper, dation Ca' #or transport'by highway according to applicable national regulations. All relevant information regarding known or suspected hazards assort etl Wilk this Wasfe� s been OR disclosed. The customer agrees to pay reasonable cost and attorney fees''incurred in the collection this -obligation. VeriuesfoN'pu'hptf es ff this=00H�"fltitltT=S II "tre'in Los Angeles County. I declare under perjury;thaj" the foregoing, is free and correct. I hereby declare that the contents of this consigrlmatt'a �6 I atigd a lfGetX,descrifasd above by the proper shipping,name, and are 'classified, packaged; marked, and labeled/placar`d, and are in all respects in'properconditldlif�l� p CAfding to appii cable and national governmental regulations. 'If exportshipment and i amShe primary Exporter, I certify,that the contents of'this con'sig' W#4t`gQdflfbtm'ttl terms'of the attached EPA Acknowledgment of Consent. I certi .that the; waste minimization statement Identified in 40 CFR 262.27(a) (if I am a large gypntft{, rigfator) or',%) (if I am a small quantity generator) is I. 6hereby ce�ify that ail information in this and all attached documents contain true and accurate descr1ptidA&6f the waste. All rel- evant information regarding known or suspected hazards associated with the waste has been disclosed. I also acknowledge that I have read and agree to the terms on this form, both front and back. signer guarantees the payment CleanTech invoices in accordance with the standard terms of Net 30. If a purchase order isnot issued, the employee authorizing the work to be performed guarantees that any invoices presented will be paid promptly. Prompt payment Is defined as payment in accordance with CleanTech standard terms of 30 days. Invoice payment is not contingent upon payment by a third party. Interest on past due accounts will be'charged at the rate of 1.5% per month until paid. WASTE MATERIALS WHICH ARE DISCOVERED TO BE NOWCON ;RN ING WILL BE SUBJECT TO ADDITIONAL CHARGES. i, TYPE OR PRINT FULL NAME ,, °§IGNATI E I hereby cerpfy,,that l have read and have the authority to bind the above listed g"enerator to the terms on the reverse side of this form. State Law requires that you keep this Receipt/Bill of Lading on file for no less than (3) years. X CleanTech Environmental Inc. g 2581. 5: Sunland Ave. 6t /d rG 0 Fresno, CA $372,5 TYPE OR PRINTF LL NAME (n EPA ID #: CAL000368136 rn Z (,, f Truck, Unit ID No." cc --- SIG E D The checked box is the designated recycling facility W Z C1 K -Pure Waterworks ❑ AJ Filter Prgdessing Crosby &Overton ❑ Veolia ES CYCleantech Environmental 8910 Rochester Ave. P.O. Box 9,04816' 1610 W. 17th Street Technical Solutions LLC 5820 Martin Rd. _J CA 91706 V 0 Rancho Cucamonga, 15131 E. Clark Ave. Long Beach, CA 90813 .1704 W. 1st Street Irwindale, 0 Q CA 91730 Industry, CA 91715 EPA # CAD028409019 Azusa, CA 91702 EPA # CAL 933003 pW, LL Ph # 909/476-9492 EPA # CAL000007432' Ph # 562/432-5445 EPA # CAD008302903 Ph # 626/812-7200 Ph # 626/333-5617 Ph # 626/334-5117