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CleanTech == SERVICEORDER RIS <br /> Environmental lnc. r„- <br /> 2581 S. Sunland Ave. • Fresno, CA 93725 17500"/ <br /> Phone: 800-531-9683 <br /> WASTE RECYCLING RECEIPT <br /> Name:Speedco Customer Purchase Order# <br /> Address:1615 I--off ]rove Sales Representative Houl <br /> City, State, Zip: Ripon CA 95366 Phone#: 563-262-6315 <br /> EPA ID#: CALOOOS08082 Federal Manifest#: 02 <br /> QUANTITY UNITS U.S.DOT DESCRIPTION CHARGE <br /> GAL. USED OIL—NON RCRA HAZARDOUS WASTE,LIQUID <br /> CA WASTE CODE 221 <br /> GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID <br /> CA WASTE CODE 134 <br /> Q <br /> OILY WATER FROM USED PARTS WASH SOLUTION— <br /> GAL. NON-RCRA HAZARDOUS WASTE, LIQUID, CA WASTE CODE 134 <br /> cc <br /> Z DRUM(S) DRAINED USED OIL AND GAS FILTERS <br /> w <br /> IVi L3 <br /> m TOTAL <br /> w The above used oil is %Lubricating oil <br /> H g %Industrial oil <br /> w ACCOUNT STATUS: ( )C.O.D. ( )OPEN ACCOUNT If open Account-payment is due net 30 days or a finance charge of 1.5% <br /> IL per month will apply. <br /> 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 <br /> U lawfully operating in accordance with a hazardous waste facilities permit issued pursuant to the Federal Act.I hereby declare that the contents of this consignment are fully and <br /> w accurately described above by the proper DOT shipping name and are classified,packaged,marked,and labeled and are in all aspects in proper condition for transport by D.D.T. <br /> 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 <br /> 0 fees incurred in the collection of this obligation.Venue for purposes of this obligation shall be In Los Angeles County.I certify that the waste minimization statement identified in 40 <br /> 1-- CFR 26227(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true.I also acknowledge[hat I have read and agree to the terms on this form both front <br /> 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 <br /> 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. <br /> Invoice payment is not contingent upon payment by a third party.Interest on past due accounts will be charged at the rate of 1.5%per month unlll pald In full.WASTE MATERIALS <br /> WHICH <br /> ARE DISCOVERED TO BE NON-CONFORMING WILL BE SUBJECT TO ADDITIONAL CHARGES. <br /> TYPE O RINT FULL NAME SIG"- ' DATE <br /> 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.Slate Law requires that both <br /> the Generator and Transporter keep this form on file for a minimum of(3)years.I hereby certify that all information in this and all attached documents contain true and accurate <br /> descriptions of the waste including that the waste is segregated and is not comingled with other waste streams.As the Generator.I acknowledge that our site EPA ID 0 is active.The <br /> waste stream listed above complies with the Waste Profile on record for the designated Facility.This document serves as written verification that the waste streams)description <br /> and constituents found above are unchanged per the Facility Generator Waste Profile Worksheet and also acts as the annual written verification for the Generator Waste Profile <br /> Worksheet of these waste streams.I declare under penalty of perjury that the foregoing is true and correct. <br /> LU CleanTech Environmental Inc. <br /> JIM <br /> 2581 S.Sunland Ave. J�� <br /> O Fresno, CA 93725 DRIVER'S NAME-TYPE OR PRINT FULL NAME <br /> ((n EPA ID#: CAL000368136 <br /> Z <br /> cc Truck, Unit ID No. t p , 2—U ' 1�i� Ll <br /> STGNATURE DATE <br /> The checked box is the designated recycling facility <br /> W Z H ❑Roadrunner Glycol,Inc. ❑Southwest Processors ❑Heritage EnvironmentalN51(20 <br /> antech Environmental <br /> U 4636 Industrial Center Dr. 4120 Bandini Blvd. Services LLC Martin Rd. <br /> U Las Vegas,NV 89115 Vernon,CA 90058 284 East Storey Road Irwindale,CA 91706 <br /> Ir w ':X EPA#NVR000088427 EPA#CAL921646037 Coolidge,AZ 85128 EPA#CAL000330453 <br /> (L rr Ph#702/379-7179 Ph#800/900-3366 EPA#AZD081705402 Ph#626/812-7200 <br /> Ph#520R23-4167 <br />