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CIeanTech -== SERVICE WORK Environmentat inc. ORDER 2581 S. Sunland Ave. - Fresno, CA 93725 180374 Phone:800-531-9683 Name: WASTE RECYCLING RECEIPT Customer Purchase Address: ---------- Sales Representative City, State, Zip: - --------- EPAID#: ------------- Phone#: QUANTITYFederal Manifest#: UNITS U.S.DOT DESCRIPTION GAL. USED OIL—NON RCRA HAZARDOUS WASTE,LIQUID CHARGE CA WASTE CODE 221 GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE,LIQUID N ir CA WASTE CODE 134 0 GAL. OILY WATER FROM USED PARTS WASH SOLUTION NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 UJI Z DRUM(S) DRAINED USED OIL AND GAS FILTERS W J TOTAL LU The above used oil is LU %Lubricating oi ACCOUNT STATUS:—( C.O.D. %Industrial oil permonth will apply. OPEN ACCOUNT If open Account-Payment is due net 30 days or a finance charge Of 1.5% 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 lawfully operating in accordance with a hazardous waste facilities Permit issued Pursuant to the Federal Act.I hereby declare that the contents or this consignment are fully and and back.Signer guarantees the Payment County. certify alto waste n obligation.Venue for purposes Of this obligation shall be in Los Angeles Coun 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.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 0 fees incurred in the collection of this I c I h h w a minimization I-- 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 Izal'On statement identified in 40 Of cleaflTech invoices in accordance with a standard terms Of Net 30 days.If a Purchase read and agree to the terms on this form both front work Performed guarantees that any invoices Presented will be Paid promptly. hase Order is not Issued the employee authorizing the .Pro Pt payment is defined as Payment In accordance with CleanTach 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 rate of 1 0 , WHICH ARE DISCOVERED To RENON-CONFORMING WILL BE SU rm BJECT TO ADDITIONAL CHARGES. .5%per month Until Paid in full.WASTE MATERIALS' PE 08 PRINT,,1q,,rvi,= I hereby certify that I have read and have the authority I SIGN URE DATE 0 bind the above listed generator to the terms found on both the f and back of this form.Slate Law requires that both 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 document descriptions of the waste Including that the waste, waste stream listed above compile is segregated and is not comingled with other waste streams. s the Generator. I acknowledge that ours ollu accurate and conslij s with the Waste Profile on record for the designated Facility.This document serves as written verification Site EPA 10#is active The uemls found above are unchanged per the Facility Generator Waste Profile Worksheet and also acts as the annual rification that the waste siream(s) ()description Worksheet I these Waste streams.I declare under penalty Of Perjury that the foregoing is true and correct. I Written vercation for the Generator Waste Profile W CleanTech Environment al Inc. 2581 S.Sunland Ave. M 0 Fresno, CA 93725 CL Z CO) EPA ID#:CAL000368136 DRIVE NAME y OR PRINT FULL NAME I-I— TrUCk, Unit ID No.P S/? o- ----------- ..... ...................... ... SIGNATU cc The checked box is this designated recycling facility IF DATE :I 1— 0 Roadrunner Glycol,Inc. 0 :J 4636 Industrial Center Dr. 11 Southwest Processors 0 Heritage Environmental >_ Q Las Vegas,NV 89115 4120 Bandini Blvd. 0 < EPA#NVROOOOBB427 Vernon,CA 90058 Services LLC eantech Environmental W UJ W _tc'120 Martin Rd. Ph#702/379-7179 EPA#CAL921646037 284 East Storey Road Irwindale,CA 91706 Coolidge,AZ 85128 C Ph#800/900-3366 EPA#AZD081 705402 EPA 0 Ph#626AL000330453 /812-7200 Ph#5201723-4167