COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

CleanTech SERVICE WORK ORDER Environmental Inc. 2581 S. Sunland Ave. a Fresno, CA 93725 _18' 0028 �? Fk Phone:800-531-9683 WASTE RECYCLING RECEIPT Name: [ Customer Purchase Order# Address: ! Sales Representative City, State,Zip: D_ In Phone#: EPA ID#; L-6 L� �( ) Federal Manifest#: 0 e-- QUANTITY UNITS U.S. DOT DESCRIPTION CHARGE `] GAL. USED OIL—NON RCRA HAZARDOUS WASTE, LIQUID r{, GCA WASTE CODE 221 `�-- GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 134 OILY WATER FROM USED PARTS WASH SOLUTION— 4 GAL. NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 LUDf9UM(S) DRAINED USED OIL AND GAS FILTERS w TOTAL s-7 in r L LU The above used oil is %Lubrlcatin F' 9 Oil- 96 Industrial off ACCOUNT STATUS: ( }C.C.D. { ]OPEC!ACCOUNT If open Account-payment Is due net 30 days or a financecharge of T.s% Ix per month will apply. p GENERATOR'S NOTIFICATION AND CERTIFICATION,Any used nil that the vansporter recelves from the generator will he transported In a seriflied used aarecyciing facility loaf is U lawfully operating In accordance with a hazardous waste facifflies permit Issued pursuant to the ROM Act,I hereby declare chat the contents of lhiS emlgnment are tufty and W aecuralsly described above by the proper DoT shipping name and are classified,packaged,marked,and labeled and are in all aspects in proper con0on fur transport by 0,0.7 M standards.All retwanl information regarding known or suspected haiards assoclated wllh this waste has heen disclosed.The custameragrees to pay reasonaEiecost and attorney fees incurrad In the coflntion of this obllgatfon.Venue for purpes45 of this gbllgalion shall be in Los Angeles County.I ceflify that the waste minlmintbrt statement identillad in 4a f— CFR 26227(a)(ii I am a large quanuty generator)or(b)(it i am a small quantity generator)is Irue,l also acknowledge that I have read and agree to the terms on lhls fora:both front jad back Signer guarantees the payment of clean7ech Invoices in accordance with the standard terms of Net 30 days.If a Purchase Order Is nut issued,the ervloyee a Whoriaing The viork performed guarantees that any invotces presented will he paid promptly,prompt payment Is defined as payment in accordance with CleanTech standard terms of net 30 days. Invoice payment is not coniinpeni upon payment by a third party-interest on past dire accounts will be charged at the rale 011-5%per month uniii paid in lull,wASTE MATERIALS WHICH ARE DISCOVERED TO DE NONCONFORMING WILL DE SUBJECT TO ADDITIONAL CHARGES. ''rte - 7YPf=OR PRI T FULL NAtM1E SIGNATURE DATE I hereby certiry that I have read and have lie aulhvrity to hind the above listed gaeuralor to the terms found on 110111 the front and back of this lawn.Stale taw requires that bolo the Generator and Transporter keep this form on Ile for a minimum of(3)years,I rlercby certify that all lnformalian in Ibis and all attached documents Morn true and aecurale descriptions of the waste including that the waste Is segregated and is not comingled with other waste streams.As Ria Generalor,I ackmowledga that out elle EPA ID a is active.The waste siream listed abdva complies with She Waste Profile on record far the designated Facliffy This document serves as written veillication that the wasieslream(s)description and consuitiorts tound above are unchanged per the Ncony Gnnerator Waste Profile Warkshaet and atss ants as the annual written verification Tor the Generator waste Profile Worksheet of these wastu streams.I declare under parially-of perjury that the foregoing is true and correct cc CleanTech Environmental Inc. LU 2581 S.Sunland Ave. M. Fresno,CA 93725 5est J W EPA 10 #:CAL000368136 DRIVER'S NAME-TYPE DR PRINT FULL NA1ufE � Truck, Unit ID No. ATU DATE The checked box is the designated recycling facility D Roadrunner Glycol,Inc. D Southwest Processors ❑Ht=r}tags Environmental eantech Environmental Ly 7-1 4636 Industrial Center Dr, 4130 Bandlni Blvd. Services LLC 5820 Maruti Rd, Q Las Vegas,NV 89115 Vernon,CA 90058 284 East Storey Road Irwindale,CA 91706 LU L EPA#NVR000088427 EPA 4�CA L921646037 Coolidge,AZ 85128 EPA#CALOOD330453 Q Ph 0 7021379-7179 Ph#8001950-3366 EPA#AZD081705402 Ph if 6261812-7200 Ph#520/123-4167