COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

SERVICE WORK 1 e a n Te ch ORDER Environmental Inc. 195343 2581 S. Sunfand Ave. • Fresno, CA 93725 Phone: 809-531-9583 WASTE RECYCLING RECEIPT Name: S Customer Purchase Order# Address: % S Sales Representative City, State, Zip: "acn 6Cf Phone#: EPA ID#: C)00 14al `'11 Federal Manifest#: 030 11vZ t4 w'A.� QUANTITY UNITS U.S.DOT DESCRIPTION CHARGE GAL USED OIL—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 221 GAL, USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 134 rr GAL. OILY WATER FROM USED PARTS WASH SOLUTION— 0 NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 4 W i DRUM(S) DRAINED USED OIL AND GAS FILTERS -7-L) - Z 1 W -- t' 1. G}0 TOTAL - Zq 0 LU The above used oil is Io Lubricating all %Industrial oil LU ACCOUNT STATUS: }C.O.D. G }OPEN ACCOUNT If open Account-payment is due net 30 days or a finance charge of 1.5% CL per month will apply. OGENERATOR'S NOTIFICATION AND CERTIFICATION:Any used rill that the transporter receives from the generator will be transported to a certified used vii racycling facility that is V lawfully operating in accordance With a hazardous waste facllities permit issued pursuant to the Federal Act.I hereby declare that the contents of this consignment are fully and LU accurately described above by the proper OOT shipping name and are classified,packaged,marked,and labeled and are In all aspects in proper condition for transport by O.O.T. m standards.All relevant information regarding known or suspected hazards associated with this waste has been disclosed.The customer agrees to pay reasonable cost and attorney fees incurred In the collection at this obligation.Venue for purposes of this obligation shall be In Las Angeles Caunty.I certify that the waste minimization statement identified in 40 l.. CFR 26227(a)(if I am a large quantity generator)or(b)(it i am a small quantity generator)is true.I also acknowledge That I have read and agree to the terms on this form both front and back.Sig nerguarantees the payment of CIeanTerh invoices in accordance with iha standard terms at Net 30 days,if a Purchase 0rder Is not issued,Iheern ployaa authorizing the work pertormed guarantees that any invoices presented will be paid promptly.Prompt payment is dat!ned 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 ba charged at the rate of 1.5%per month until paid in full.WASTE MATERIALS WHICH ARE DISCOVEREO TO BE NON-CON FOR MING WILL BE SUBJECT TO ADDITIONAL CHARGES. TYPE OR PRINT ULL NAME SIGNATURE DATE I he, Certify that I have read and have the authority to bind the above listed narator to iha terms found on both the front and back of this form.5late Law requires That both the Generator and Transporter keep this form on file for a minimum of(3)years,I hereby certify that all intormalion in this and all attached dncuments Contain true and accurate descriptions of the waste including that the waste is segregated and is not comingled with other waste streams.As the Generator,i acknowledge that oursiie EPA Ip K is active.The waste stream listed above compiles with the Waste Profile on record for the designated Facility.This document serves as written verification[hat the waste streams}description and constituents found above are unchanged per the Facility Generator Wasle Prefile Worksheet and also acts as the annual'written verification for The Generator Waste Prefile Worksheet of these waste streams.I declare under penahy of perjury that the foregoing is true and correct, 9: CleanTech Environmental Inc. LU 2581 S. Sunland Ave. l 1 0 Fresno, CA 93725 p 'S-NAM -TYPZE AME IL (y EPA ID#:CAL000368136 Q L]UZ_7j Truck, Unit ID Na. IGNATU The checked box is the designated recycling facility W z ❑Roadrunner Glycol,Inc. ❑Southwest Processors ❑Heritage Environmental 'QCleantech Environmental Com? 4636 Industrial Center Dr, 4120 Oandini Blvd. Services LLC 5820 Martin Rd. > v Las Vegas,NV 89115 Vernon,CA 90058 284 East Storey Road Irwindale,CA 91706 Cr. w < EPA#NVR000088427 EPA#CAL921646037 Coolidge,AZ 85128 EPA#CAL000330453 �, p� Ph#7021379-7179 Ph#8001900-3366 Ph#52017231406702 Ph#5281812-7200