COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

SERVICE WORK lea n Tech ORDER Environmental Inc. 197134 2581 S. Sunland Ave. • Fresno, CA 93725 Phone; 800-531-9683 WASTE RECYCLING RECEIPT Name: �� LKS Customer Purchase Order# 1 f' �v Address: � � ]�� Sales Representative City, State, Zip: i r 9`5-.3U Phone #: E PA I D#: 04L 0 V 3 Federal Manifest#: QUANTITY UNITS U.S.DOT DESCRIPTION CHARGE GAL USED OIL—NON RCRA HAZARDOUS WASTE, LIQUID Lt o CD CA WASTE CODE 221 C- GAL, USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 134 cc OILY WATER FROM USED PARTS WASH SOLUTION— GAL. NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 a Liu DRUM(S) DRAINED USED OIL AND GAS FILTERS m TOTAL O W The above used oll is___%Lubricating all %Industrial oil I— J ACCOUNT STATUS: { )C.O_D. f l OPEN ACCOUNT If open Account-payment Is due net 38 days or a finance charge of 1.5% fl per month will apply. 0GENERATOR'S NOTIFICATION AND MITIFICATION:Any used oil that the Iransporter receives irem the generator will be transported to a cartltied used nil tKyClIng facill that Is Ulawfully operating in accordance with a hazardous waste facilities permit issued pursuant to the Federal ACR.I hereby declare that the contents at Ibis consignment are fully and W accurately described above by the proper DOT shipping name and are classified,packaged,marked,and labeled and are in all aspects in proper conalan for transport by D.0_T_ X1 standards.All relevant Information regarding known or suspected hazards associated with this waste has been disclosed.The cuslomer agrees to pay reasonable Cost and allornay O fees incurred In the miieetlon of this obligatian,venue for purposes of this obligation shall be in Los Angeles Counly.I certify that the waste minimization siatement identified In 40 F_ CFR 26227(a)(if I am a large quantity generator)or(b)l[f[am a small quantity generator)is true.I also acknowledge that I have read and agree to the terms on chis term bath bent and back.Signer guarantees the payment of CleanTech invoices in accordance with the standard terms of Nei 30 days.If a Purchase Order is not IGsued,the employee authorizing the work performed guarantees that any Invoices 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 contingent upon payment by a third party.Interest on past due accounts will he charged at the rate of 1.5%per month until paid infull.WASTE MATERIALS WHICH ARE DiSCOVEREO TO BE NON-CONFORMING WILL BE SUBJECT TO ADDITIONAL CHARGES. TYPE❑R PRINT FRILL NAME ATUR DATE I hereby certify that i have read grid have the authority to bind the above lisQaenerator the terms tountl on both the fro and back of this form.Slat#Law requires that doth the Generator and Transporter keep this farm on file far a minimum of(3) certify that all information in Ih[s d all allaehed documema contain true and accurate descriptions of the waste including Mal the waste is segregated and is not cther waste streams,As the Ge Ear,l acknowledge that our site EPA TD 0 is active.Thewaste stream listed above complies with the Waste Profile on record for the as written verillcation that the waste streamis)description and conslituents found above are unchanged per the Facility Generator Waste Profile Warksheet and also acts as the annual wrilen verification lortha Generator Waste Profile Worksheet at These waste streams.I declare under penalty of perjury that the lgregoiag is true and correct, Ix CleanTech Environmental Inc. 2581 S. Sunland Ave- Ct4��tA5-' L 0 Fresno, CA 93725 DRIVER'S NAME-TYPE OR PRINT FULL NAME CL (n EPA IQ #:CAL000368136 4 cc Truck, Unit ID No. 93/67 67 _ SIGNATURE DATE The checked box is the designated recycling facility LU Z > ❑Roadrunner Glycol, Inc. ©Southwest Processors C Heritage Environmentaln ech ER vironrnental L) j 4636 Industrial Center Dr, 4120 Bandirti Blvd. Services LLC 5824 Martin Rd. cc v Las Vegas, NV 89115 Vernon,CA 90058 284 East Storey Road Irwindale,CA 91706 W L EPA#NVR000088427 EPA#CAL921646037 Coolidge,AS 85128 EPA#CAL000330453 CL fx Ph#7021379-7179 Ph#8001900-3366 EPA#AZD081705402 Ph#626/812-7200 Ph#5201723-4167