COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

leanTech SERVICE == CWORK ORDER Environmental Inc. 288675 5820 Martin Road - Irwindale, CA 91706 Phone: 626-812-7200 WASTE RECYCLING RECEIPT Name. S e e-Ac ] Customer Purchase Order# Address: — X Dr. Sales Representative City, State, Zip: R,ocsr,, 0 Phone M EPA ID #: 7 Federal Manifest#: e3,'5oo Le Z'7? Latf 5 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 p[ CA WASTE CODE 134 4 GAL OILY WATER FROM USED PARTS WASH SOLUTION— oC NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 W z i 1 OFiUM(S) DRAINED USED OIL AN AS FILTERS '��,r- � + C� "1 1 m c� TAT L S'eA- w r '7-75 Z = 53 1 7n 3 I- _J The above used all is °6 Lubricating oil %Industrial 61 LL ACCOUNT STATUS: { y C.O.R. ( y OPEN ACCOUNT It open Account-payment is due net 30 days or a finance charge of 1.5% 0 D per month will apply. 0 GENERATOR'S NOTIFICATION AND CERTIFICATION. Any used oil that the transporter receives from the generator will he transported to a certified used oil recycling lacili- W ly that is lawfully operating hr accordance wllh a hazardous waste tacitines permil issued pursuant to[Ire Federal Act, I hereby declare that Ilie contents of this consign- D4 ment are fully and accurately described above by the proper shipping name altd are classified,packaged,marked,and labeled and are in ail respects in proper conditlon Q for transport by highway according to applicable national regulations. All relevant Information regarding known or suspected hazards associated wo this waste has been disclosed. The customer agrees to pay reasonable cost and attorney fees incurred in lite collection of Ibis obligation. Venue for purposes of this obilgation shall he in Los Angeles County. I declare under perjury Ilial Ilse foregoing Is true and correct- I hereby declare Iha[the contents of Phis consignment are tullyandaccuratety described above by lire proper shipping name,and are cfassffiad,packaged,marked,and labeled/placard,and are in all respects in ompercondition[or transport according to appll- cabia and national governmonIat reg utalions- Ii export 511Ipmenl and I am the primary Exporter,I certify that the contents of this consignment conform to forms of Ilie atlachad EPA Acknowledgment o1 Consent. P certify that Itte waste Imillimization statement fdentiliad in 40 CFR 2E217(a)011 ant a large quantity generalorl or(b)(if I am a small quantity generalor)is true. I hereby certify that all information in this and all allached documents contain true and accurate descripfionsof(lie waste. All rel- evant Information regarding known or suspected hazards associated vitt Ilse waste has been disclosed. i also acknowledge that I have read and agree to the torms on INS form,both front and batik. Signer guarantees the payment CPeanTech invoices in accordance with the standard terms of Net 30- fi a purchase order is not issued, the er player authorizing the work in be performed guarantees that any invoices prose led will be paid promp(ly_ Prompt payment is defined as payment fn accordance will feanTech standard terms of 30 days. Invalee payment Is not contingent upon p, mens by a third pally. Interest on past due accounts will he charged at the rate of t. V.per month witil paid,WASTE MATERIALS WHICH ARE DISCOVERED BEN -CONFORMIN WILL BE SUBJECT To ADDITIONAL CHARGES. TYP "PRINT FULL NAME SIGNATURE DATE I hereby aerfily that I have read and have the authority to bind a at)cve listed generator to the terms on the reverse side of this Corm. State Law requires that you keep this Receipt/Bill of Lading on life for no less than(3)years. CleanTech Environmental Inc. Lull 5820 Martin Roadcc kAl I„ p Irwindale, CA 91706 � -T EOR PR ULL NAME cn EPA ID#:CAL000330453 a Truck, Unit Id No. GNATU DATE ❑ L`3 Lu z } _ K-Pure Waterworks Cl Crosby&Overton EJ Heritage Environmental Services LLC ,CieanIfch Environmental �y � 891 U Rochester Ave. 1610 W.17111 Streel 284 East Storey Road 58211 Martin Rd. >- U Rancho Cucamonga, Long Beach,CA 90813 Coolidge,A2 85128 Irwindale,CA 91706 0 .1 CA 91734 EPA#CA0028409019 EPA#AZD081705402 EPA#CAL000330453 0. fr Ph#9091476-9492 Ph#5621432.5445 Ph#520/723-4167 Ph#6261812-7200