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1e Tec � SERVICE ORDER Environmental ins. 195462 2581 S. Sunland Ave. - Fresno, CA 93725 Phone: 800-531-9683 WASTE RECYCLING RECEIPT Name: `'`"�' ' Customer Purchase Order# Address. TSz14 ilio r rr;rive Sales Representative �lcAjSE City, State,Zip: s-i ar,�.rix l'Ftane#: ta- .a� S EPA ID #; 'T �"- Federaf Manifest#: X701 l..�QJ JPS MDOT DESCRIPTION CHARGEJD OIL-NON RCRA HAZARDOUS WASTE, LIQUID1 I ASTE CODE 221 Nb D ANTI-FREEZE-NON RCRA HAZARDOUS WASTE, LIQUID ASTE CODE 134 WATER FROM USED PARTS WASH SOLUTION- Q -RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 tr � INED USEC OIL ANC GAS FILTERS t FOTAL LU The above used oil is %Lubricatingoil industrial oil ACCOUNT STATUS-. { }C.O.D. { 1 OPEN ACCOUNT If open Account-payment is due net 30 days or a finance charge of 1.5% iL per month will apply. N d GENERATOR'S NOTIFICAPON AND CERTIFICATION;Any used all that the transporter receives from the generator will be transported tea certined used all rGynog facility that N 0 lawfully Operating in accordance with a hazardous waste facllities permit issued pursuant to the Federal Act,f hereby declare that the contents of this consignment are fully and LU accurately described above by the proper OOTshipping name and are cfassifted,packaged,marked,and labeled and are In all aspects in propereonditlon for transport by D-O.T. im standards.All ralevartl information regarding lrnown or suspected twards associated with this waste has peen disclosed-The customer agrees to pay reasonable cost and attorney fees incurred in the ceiiedlun of this obtigarroO.Venue for purposes or Ihls obligation shall be in Los Angeles Zounty.I rOily that the waste tninEmim tion slab¢meor ldentlfied in AO F- CFR 26227(a)(if I am a large quanllty generator)or(b)011 am a small quantity generator}Is true,I also acknowledge that I have read and agroe to the rennson Ibis farm both front and back.Signer guarantees the payment of cwaTech invoices In accordance with the standard terms of Net 30 days,It a Purchase Order is not issued,the employee authorizing the work performed guarantees that any invoices presentad will be paid promptly.Prompt payment is delined as payment in accordance%vilh CleanTeO standard kMS of net 3o days. invoice payment is not contingent upon payment by third party.Interest on past due accounts Oil be charged al the rate of 1.510 per month until paid in full WASTE NfATFRIALS WHICH ARE DISCOVERED TO BE NON—CONFORMING WILL BE SUBJECT TO ADDITIONAL CHARGES. PE OR PRiNT FURL NA E � r SIGNATU DATE I hereby certify that I kava read and have the authority to bthd the above listed generat a the terms fdund op�pa i land back of Itds form.Slate Law requires that both the Generator and Transposer keep this form on file for a minimum of(3)years.I h eby certfly that all Information in th€s and all altached documents cwWI'rr true and accuraia descriptions of the waste Including that the waste is segregated and Is not comingied with other waste streams.As the Generator,I acknOwledge that our sire fFA IO y is active.The waste stream fistedat)00 compiles with the Waste Pr0111e on record for the desionaled Facility.This document serves as wrhlen verilication that the wasteslream(s)ciescriptlon and constfluenls lound atrove are unchanged per She Faatlily Generalor waste pMllje Worksheeland Olso acts as the annual writtenverittcatiorl rar IM Grneralor Waste Profile WeAsheet of these waste streams,I declare under penalty of perjury that the laregolno is true and correct. [170CEF CleanTech Environmental Inc. LLI 2581 S. Sunland Ave. resno,CA 93725LU Lrta[ EPA ID#: GALt7a0368136j1)FIR'S AME-TYPE OR P T FULL NAME(Druck, Unit ID No.. - r SIG TU#�E DATE C3 0 The checked box Is the designates!recycling facility J ❑Roadrunner Glycal, ins. 0 Southwest Processors ❑Heritage Erlvirunmenta f Wealrtech Environmental 4636 industrial Center Dr, 4120 Band ini Blvd. Services LLC 5820 Martin Rd, cc U U Las Vegas.AIV 89115 Ve►non,CA 90058 264 East Storey Road - Irwindale,CR 9i706 LU EPA#NVR000088427 EPA#CAL921646037 Coolidge,A7 85128 EPA#GALG 0330453 CL� LL Ph 4 702)379-7179 Ph 0 8001900-3366 EPA#AZOO81705402 Ph#6261812-7200 Ph#5201723-4167