COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

Received on 01/03/2022 Ch SERVICE WORK C1 e a n Te ORDER Environmental Inc. 172467 2581 S. Sunland Ave. - Fresno, CA 93725 Phone: 800-531-9683 WASTE RECYCLING RECEIP Name: en m G Customer Purchase Order# Address: r ' Sales Representative l City, State, Zip: P 1 Phone#: l k (� EPA ID#: Federal Manifest#: L 0 L _)J� ' OUANTITY UNITS U. DESCRIPTION CHARGE GAL. USED OIL NON RCRA HAZARDOUS WASTE, LIQUID CAA E CODE 221 GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 134 GAL. OILY WATER FROM USED PARTS WASH SOLUTION— NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 a W DRUM(S) DRAINED USED OIL AND GAS FILTERS LLJ TOTAL , W The above used oil is l4 Lubricati g oil 1 industrial oil W ACCOUNT STATUS: ( }C.O.D. O OPEN ACCOUNT it open Account-payment is due net 30 days or a finance charge of 1.6% d per month will apply. 0 GENERATOR'S NOTIFICATION AND CERTIFICATION:Any used oil that the Transporter recatves from the generator will be transported to a certified used oft recycling facility that is U lawfully operating in accordance wilh a hazardous waste facilities permit Issued pursuant to the Federal Act.1 hereby declare that the contents 01 This consignment are fully and accurately described above by the proper DDT shlpping name and are ciassilied,packaged,marked,and iaboled and are In all aspects in proper condition for transport by 9.0.1. D3 standards.All relevant Information regarding known or suspected hazards associated with this waste has been disclosed.The customer agrees to pay reasonable cost and att0may � 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 0 CFR 26227l am a large quantity generator)or(b)(It 1 am a small quantity generator)is true.I also acknowledge that I have read and agree to thetarms on this form both pant and back.Signer guarantees the payment of CleanTech invoices In accordance with the standard terms of Net 30 days.It a Purchase Order is not issued,the employee autharizing the work performed guarantees[hat any invo}ces 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 rate of 1.51/.par month until paid in full.WASTE MATERIALS WHICH ARE DISCOVERED TO BE NON-CONFORMING WILL BE SOBJECTTO ADDITIONAL CHARGES, SNATURE TYPE OR PRINT FULL NAME c DATE I hereby certify That I have read and have the authority to bind the above listed generator to the farms sound on both the Iront and back at This loan.Stile 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[his and all attached documents contain true and accurate 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 silo EPA If)4 is active.The waste stream listed above compiles with the Waste Profile on record for the designated Facility.This document serves as written verification that the waste strearn(s)description and conslllueols found above are unchanged per the Facility Generator Waste Profile Worksheet and 3139 acts as the annual written MaHNsatfon for the Generator Waste Prollle Wnrftsheei of these waste slreama.1 declare under penalty of perjury that the foregoing is true and correct. fr CleanTech Environmental Inc. Uj 2581 S. Sunland Ave. t, p Fresno, CA 93725 DRIVER'S NAME-TYPE OR P NT F LL NAME 0. EPA ID #:CAL000368136 Truck, Unit ID No._ I DTE The checked box is the designated recycling facility U1 2 ❑Roadrunner Glycol, Inc. ❑Southwest Processors ❑Heritage Environmental Cleantech Environmental M 4636 lndustriai Center 0r. 412013andini Blvd. Services LLC 820 Martin Rd. �. t] Las Vegas,NV 89115 Vernon,CA 90058 284 East Storey Road Irwindale,CA 91706 W EPA#NVR000086427 EPA#CAL921646037 Coolidge,AZ 85128 EPA#CAL00033045Z CL cc Ph#7021379-7179 Pts#8001900-3366 EPA#AZD081705402 Ph#6261812-7200 Ph#520!723-4167