COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

CleanTech SERVICE � == WORK ORDER Environmental Inc. 268666 5820 Martin Road e Irwindale, CA 91746 Phone: 626-812-7200 WASTE RECYCLING RECEIPT Dame: _� t7e" � Customer Purchase Order# Address: i � � Sales Representative City, State, Zip: L Phone #: EPA ID #; Federal Manifest #: 0300 l o sq� +VAS QUANTITY UNITS U.S.DOT DESCRIPTION CHARGE GAL USED OIL-NON FICRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 221 GAL. USED ANTI-FREEZE—NON MCRA HAZARDOUS WASTE, LIQUID cc CA WASTE CODE 134 ❑ GAL. OILY WATER FROM USED PARTS WASH SOLUTION- NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 Z r DRUM(S) DRAINED USED OIL AND GAS FILTERS r f ry � r � TOTAL �5 $2 7'!�o W The above used oil is 9Q Lubricating nil %Industrial off ACCOUNT STATUS. { }C.O.D. { ] OPEN ACCOUNT If open Account-payment is due net 30 days or a finance charge of 1.5%4 ❑ per month will apply. U GENEHATOWS 40TWICATION AND GERTIFIGA-PON: Any used ail that the transporter receives from the generator will be transported to a certified used ail recycling faclli- Ld ly that is Invluily operating in accordanca with a hazardous waste facilities permit issued pursuant to the federal Act. I hereby declare that Ihecontents of this consign- or ment are fully and accurately described above by the proper shipping name and are classified,packaged,marked,and labeled and are in all respects in proper condition ❑ fpr transport by highway according to applicable national regulations. All relevant information regarding known or suspected hazards associated wilh[his waste has been disclosed. The customer agrees to pay reasonable cost and attomay fees incurred in the collection of this obilgation. Venue for purposes at this obllgalion shall he in Los Angeles County. I declare under par vry that the foregoing is true and correct. I hereby declare that the contents of this consignment are fuiiyand accurately described above by the proper shipping name,and are classified,packaged,marked,and labeled/placard,and are in all respects in proper condition for transport according to appli- cable and national governmental regulations. If expuR shipment and I am the primary Exporter,i certify that the contents of this consignment conform to terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b=(if I am a small quantity generator)Is true. I hereby certify that all Inlormation in this and all altached documents contain true and accurate descriptions of the waste. All rel- evant inlormatfon regarding known or suspected hazards associated with the waste has been disclosed. i also acknowledge that I have read and agree to the terms on this farm,both front and back. Signer guarantees the payment CleanTech invoices in accordance with the standard terms of Net 30. If a purchase order is not issued, the employee authorizing the work to be performed guaranlees that any Invoices presented will be paid promptly. Prompt payment is defined as payment in accordance WO CleanTech standard terms of 30 days. Invoice payment is not contingent upon payment by a third party. Interest on past due accounts will be charged at the rate of 1.51/.par month until paid.WASTE MATERIALS WHICH ARE DISCOVERED TO BE NON C RittING WILL 8 SUBJECT TO ADDITIONAL CHARGES. TYPE OR PRINT FULL NAME SIGNAT DATE I hereby certify that I have read and have the authority to bind the above listed generator o the terms on the reverse side of this form; Slate Law requires that you keep this Receipt/Bill of Lading on file for no less than(3)years- cc CleanTech Environmental Inc. 5820 Martin Road 14 iDo pqo Irwindale, CA 917f]5 DRIVE 'S NAME-TYPE OR PRINT FULL NAME (n EPA I a#: CAL000330453 Z �r ZC; Truck, Unit ID No. I URE DATE The checked box is the designated recycling facility u.1 Z F1 K-Pure Waterworks I__ Crosby& Overton I__-I Heritage Environmental Services LLCLj leantech Environmental J 8910 Rochester Ave. 1610 W. 17th Street 284 East Storey Road �! 5820 Martin Rd. O Rancho Cucamonga, Lang Beach,CA 90813 Coolidge,AZ B5128 lRvindale,CA 91706 Uj w � CA 91730 EPA#CAD028409019 EPA#AZD081705402 EPA#CAL000330453 or Ph #9091476-9492 Ph#5621432-5445 Ph#5201723-4167 Ph #6261912-7204