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SERVICE WORK <br /> == CieanTecl� ===� ORDER <br /> Environmental Inc <br /> 2581 S. Suniand Ave. a Fresno, CA 93725 0 7 <br /> Phone: 800-531-9883 <br /> WASTE RECYCUNG RECEIP J <br /> Name: � <br /> Address; <br /> CLlstornei Purchase Order# <br /> I5�5 �Q felt <br /> Sales Representative <br /> city.State, dip: i � 95310 <br /> EPA ID#: <br /> Phone #; <br /> Ir pd� <br /> y 2 w, <br /> QUANTITY UNITS 11.8,DOT DESCRIPTION Federal Manifest#: AS <br /> fY}� <br /> GAI_. USED OIL-NON RCRA HAZARDOUS WASTE, LIQUID CHARGE <br /> rLJJ CA WASTE CODE 221 <br /> GAL. USED ANTI-FREEZE-.NON RC RA HAZARDOUS WASTE. LIQUID <br /> a <br /> CA WASTE CODE 134 <br /> ❑ <br /> GAL. OILY WATER FROM USED PARTS WASH SOLUTION <br /> � <br /> Q NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 734 <br /> fr. <br /> wDRUM(S) DRAINED USED OiL AND GAS FILTERS <br /> C7 <br /> � GtY1 i <br /> TOTAL, <br /> LLI <br /> i' The above used u Jsui � *,o Lubricating oti 7.L4_5 <br /> al <br /> ACCOUNT STATUS: ( )C-0-D, { y OPEN ACCOUNT It Op� @� °Faymelnt isduenet 3tl days or a Nrtance charge of y,gg•, <br /> rL per rrranth will apply, <br /> Q <br /> GENEflATdn'S JVO n accor an ANO h afiazICATION:Any used oil that the Itanspngar racelves morn rhe generalor wlri be transported to a rartiile used I'd re Ong facility that Es <br /> U lawfully operalVng in accordance 4vlth a hazardous waste facilNies permit Jssued pursuant to the Federal Act.J hereby declare that the contents of is cWrMwNrin!are hilly and <br /> W accurately described above <br /> by <br /> 0 standards,AiI n the co information o on swardingobligati known or suspeoted hazards as5ocJatad wflh this wade has been ad and ar the ll asps t$agrees To pay reasarlahue cost and alloy - <br /> the proper Or1T shipping+rams and are dassifJed,packaged,marked,and label and are in aR aspects in proper rn"dJs CO for transport by fully <br /> and <br /> d. <br /> ❑ fees Incurred in the t olJacllan of Ihfs nbrrgation.venue Tor purposes of Ibis ohilgallan about he In Los Arne es County.I certify that the waste es To Payton s mbl ec cost <br /> acid ad!n 4O <br /> ey <br /> f� CFR 2f3227(a)Iif J am a targe quanGtygeneratpr]fly{b)(III am a srnali quantify generator)is true.f also acknowledge that I have read and agree Ia the terms-on thisfflrm Nth frflnl <br /> and hack.Signer guarantees that <br /> Of CJcanTach invo-reas in accordance wJrh the standard farms of Nat 3f1 days.I!a Purchase Order is not Issued,Ire e <br /> Mork performed guaranreas[hat any invelces presented wIJJ he paid promptly.prompt payment is derivedet paynta. fn accordance derwah s not tech stand <br /> Invoice payment is+lot contingent upon payment by a Ihfrd party. the <br /> interest an past due accounts vrrll be charged a[the rate Of 1.5%per month until pald In ru11p114A$i f MATERIALS <br /> WIfIGN ARE OIsCOVEREt1 To AE HON-CONFORMING WILL BE SUBJECT TO AODITtOHAL CIIARCES, ard.WAS of net E days. <br /> TYPE[]R PAIni'r FULL NAME � �"�3'�� <br /> I hereby certify that f nava read and have the on life <br /> id hind the above r+sled generator To the farms iolund an doth the[rent and tacit of Ibis form State Caly requires that bosh <br /> the Generarar and Transporter keep his farm an fife for a GATE <br /> minimum of s <br /> udiag <br /> daserfptiea oIrthe waste mompjjL that lite was is segregaledand fs not eumingted wills ether waste screams,As the Generator,I x4towtedge that oursole FPA 1;is acllve.The <br /> y years.f hereby cerufy ihat afJ informatlan in this and all atrachad documents cordarn irue and accurate <br /> waste stream rinsed aboveove arses with the Waste Prolile on record for the designated Faculty.Thls document serves as wrJlleh verincalron fha!the waste sfream[s}deserlplion <br /> and censuluettts fauna above ora unchanged per the Faclirfy Generafne Waste Proiue Warksheaf and aura acts r rhe annual n veHf valitin then tar the waste <br /> prodoI!on <br /> Woftheel of these waste streams.I declare under penalty orperjury Ihar the foregoing is True and correct, <br /> � GleanTeeh Environmental Inc. <br /> le <br /> � ;2581 S.SLtnland Ave. <br /> C] Fresno, CA 93725 <br /> CL <br /> EPA ID#:CAL000368136 DRIVER'�S JVAiMtra, <br /> ME-TYPE OR PRINT FULL NAME <br /> 4 <br /> M Truck, Unit ID No. r+� f-Z3-2a p <br /> The checked box is the designated recycling faculty SiGIVAFUFIP DATE <br /> Z_� ❑Roadrunner Glycol, inc. ❑Southwest Processors <br /> U - 4636 Industrial Center Dr. 4120 Bandini Blvd. 0 Herita0e Enyirnnrnenta! imeantech Erlvironlilental <br /> CC 0 U Las Vedas,NV 99115 Vernon,CA 90058 Services LLC 5820 MJartirl Ad. <br /> LU Uj LL EPA#NVROCCO88427 EPA#GAL92i646037 284 Easi Storey Road Irwindale,CA 91706 <br /> Ph 7421379 7179 Ph#80e}l90G-3366 Coolidge,A2 85128 EPA# 1705 <br /> -3366 <br /> EPA#A7D091705402 E #6251812-7200 <br /> Ph#520/723-4167 Ph <br />