COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

CleanTe SERVICE WORK �,h ORDER Environmental Inc, 2581 S. Sunland Ave. . Fresno, CA 93725 169467 Phone: 800-531-9683 odd WASTE RECYCLING RECEIPT Name: Speedco Address: 1$1$ Hoff Drive Customer Purchase Order# Sales Representative HOUSE City, State, Zip: Ripon CA 95366 Phone#: 663-262-6375 EPA ID#: CAL000 Federal Manifest QUANTITY UNITS U.S.DOT DESCRIPTION 3 USED OIL—NON RCRA HAZARDOUS WASTE,LIQUID HARGE, (y GAL. CA WASTE CODE 221 GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID rc CA WASTE CODE 134 00 GAL. OILY WATER FROM USED PARTS WASH SOLUTION— q NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 X W DRUM(S) DRAINED USED OIL AND GAS FILTERS Z W (3 } m G1 / Wp p Q (��'l.- TOTAL I.- The ove used oil ism_%Lubricatingoil J ACCOUNT STATUS: ( )C.O.D. /o Industrial oil ( )OPEN ACCOUNT If open Account-payment is due net 30-days or a finance charge of 1.5% d per month will apply. 0 GENERATOR'S NOTIFICATION AND CERTIFICATION:Any used oil that the transporter receives from the generator will be transported to a certified used oil recycling facility that is V lawfully operating in accordance with a hazardous waste facilities permit issued pursuant to the Federal Act.I hereby declare that the contents at this consignment are fully and LU accurately described above by theproper DOT shipping name and are classified,packaged,marked,and labeled and are in all aspects in proper condition for transport by D.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 of this obligation.Venue for purposes of this obligation shall be in Los Angeles CounI c . ertiry that the waste minimization statement Identified in 40 CFR 26227(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)Is true.I also acknowledge that I have read and agree to the terms to this form both front ty and back.Signer guarantees the payment of cleanTech invoices in accordance with the standard terms of Net 30 days.If a Purchase Order is not issued,the employee authorizing the work performed guarantees that any invoices presented will be 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 be charged at the rale of 1.5%per month until paid in full.WASTE MATER WHICH ARE DISCOVERED TO BE NON-CONFORMING WILL BE SUBJECT TO ADDITIONAL CHARGES. IALS �� _ TYPE OR PRINT FULL NAME —/� SIGNATURE DATE I hereby certify that I have read and have the authority to bind the above listed generator to the terms found on both the front and back of this form.State Law requires that both the Generator and Transporter keep this form onfile fora minimum of(3)yea descriptions of the waste including that the waste rs.I hereby certify that all information in this and all attached documents contain true and accurate waste stream listed above complies with the Waste Profile on record fis segregated and if not comingled with other waste streams.As the Generator.I acknowledge that our site EPA ID#Is active.The or the designated Facility.This document serves as written verification that the waste streams)description and constituents found above are unchanged per the Facility Generator Waste Profile Worksheet and also acts as the annual written verification tar the Generator Waste Profile Worksheet of these waste streams.I declare under penalty of perjury that the foregoing is true and correct. Jui CleanTech Environmental Inc. 2581 S.Sunland Ave. Fresno, CA 93725 Z EPA ID#:CAL000368136 DRIVE E-TYPE OR PRN NAME cc Truck, Unit ID No. b IGNATATE The checked box is the designated recycling facilityLLJ ❑Roadrunner Glycol,Inc. ❑Southwest Processors ❑Herita a Environmental 4636 Industrial Center Dr. 4120 Bandini Blvd. g xleantech Environmental Las Vegas,NV 89115 Vernon,CA 90058 Services LLC 5820 Martin Rd. EPA#NVR000088427 284 East Storey Road Irwindale,CA 91706 Ph# NVR000088 EPA#CAL921646037 Coolidge,AZ 85128 EPA#CAL000330453 Ph#800/900-3366 EPA#AZD081705402 Ph#626/812-7200 Ph#5201723-4167