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SERY4 <br /> CleanTech <br /> Environmental Inc. 1� <br /> 2581 S. Sunland Ave. i 1=resna. CA 93725 ` - <br /> I r. Phone:600-531-9683 <br /> WA$TE RECYCLING RECEIPT <br /> Customer Purchase Order 4 <br /> ' — Sales F�epresenlalive t.�r - 4 <br /> ' Address; <br /> City.State.Ztp: Phone <br /> {R' FPA ID N: , Federal Manifest it: <br /> . 1 <br /> QUANTITY UNITS U-5,DOT DE5C111PTtQN <br /> CHANGE <br /> GAL. USED OIL-NON RCRA HAZARDOUS WASTE.LLCIUID <br /> L CA WASTE CODE 221 <br /> GAL. USED ANTI-FREEZE-NON RCRA 1iAZARDOUS WASTE,LIQUID <br /> I + CA WASTE COPE 134 <br /> GAL, OILY WATER FROM USED pAFrr5 WASH SOLUTION- <br /> QNON-RCRA HAZARDOUS WASTE.LiQUIt]. CA WASTE CODE 13+t <br /> - ' Ix w putt M(SI DRAINED USED OiL AND GAS FILTERS <br /> NINA <br /> TOTAL <br /> F <br /> %Lubrlcrlin4 041--%6inawanal oil That e4om used 0111 s<- marl la dug rxM 30 drys or i 11t-nq charge of 1 <br /> ACCOUNT STATUS: <br /> W OPEN+4CGpUNi H opgn Jos ln} PsY f <br /> a –paw'IMa ih will apphr. r,�ne+ru,so�l+CI ro= wgd ox nr t"txany twt% <br /> 2 atWIFIATO1t'E IIDRFICATION AND ClfwnnCATiDN.AIry used a1 thu lin i i lspar+ar rani to A true*the M art Nrf and <br /> C. rd,nu Md.and"bill ihd m n aw&peas.n C'OOM emderm roe iraniwrl tel 4 0 T <br /> 4n11.1r}opelalnW M atrm dally+with a NIPd+,us wASkf taGllSea 9aflnll(Stilled gail3Wn1 hl AM HdirM ACI.I hhWf derlsre Ir+al,ha Cnrtent5 a1 H+a M <br /> aCCD,at*de!{rll,ed abu+i In IM pr,.Per'Gy VhpPing imirm and art t110511 ld.Wki4 TTM tui141ner Wm to Par risW"M c4s't Arta'lTurpfrT <br /> . ! I i1;11daN!AM nlNtibnl inlnrmfhOn nd.5i dl MW"Or}u1pPCled tW6rd3 iLWL11fd*f-t thLt MaSIR has Wen g wnil C+r,gs11 IIIfa1fIILri11p,tifattman[.darlUTnd in 40 <br /> r ` ` NN WKUIW In IM CV16KIW 0 Ihlt V1Ui04I6W�flbl[11 1 nt 1 Sn�II GWnjmki 11}gerd"ujls I".I rsotit in Los k rkL modge"1 hm IMd hV 49M to"Itrwa On ilRs roan nom 1+4nt <br /> 1 yPJ R W27{a31d 1 am a 41 pt gwnhh p+ <br /> 1 WW 4aCk kger OLp4amIMS the payn>rn+Qf C%4n1tCh ilhYdCfE In s4LOIdiPtN With <br /> pro th!scapdiro,4rd Ord&5CI dws It apllKlta4�F �ill1 CWVTOCA 31yt�ardder 15 6A knUld.d*MHItrr�r DC Be'X dffs <br /> wd�lerrywm o q,f ranIeif Ihl1 WW iM�kIs Pr►Srn1Mf WWI t,s Iuld prompCN Prompt piY+runt dlnnsd ss gay�nnf In actaldu+ce <br /> r .. TD <br /> NON N+.vrce i,annnl a M1 C4nnngtnt nqc'Iti1,went try 1 thlyd Party Int mit on put d,M h-mium+Mq>1e[harl7+4 ri ltN rswt a 1��9M Inpnlh llnl ped w11uM wrAsT>1 wrATERIALS <br /> WKO ARE 018COVIlk4D t4 sE NON COKrpRMING'NILL IE MAOMAO �IDDi►lU1�I►"A"GES' <br /> L i <br /> x( 'r t 4 MNATIJR gr11'E <br /> i T�pE <br /> 01—PRINT fUl L FusMIS <br /> +i1 ud 76 4and tM Above ttitwd 4sr�RTN T4 1rw krrtF i991nd M t�41r 111E lydPl and back OT iS,tl form Slf Lek ftou m IV 15r11R <br /> _ I hertbV Ca,f N Irml 1 hay*road mb havM tM h"tor <br /> wM�tnt,atd+aM1d 11 rnsDorl,lr kia0 Ir.n harm Wr iqas m1 ind h hot C4n;�glop w11 ptM LSIy�a1iM as Ina�Gw6at r.-1 itk k,nwi r 1'w our sA►E Ik 16 16 7rt1 u <br /> `"" d.st+�ptawrS de Ina wutt d+Stiednp[nr,I7te ralTa Id 1t9 f0a+ sings"w"Mer retflUroffi thtl tW rials shyialtsl MigIPlldp <br /> + 4 �_ want•I nem Y,lid atrlwr rtomVM3 wdA Int 5Ya31f prn151e an raCMd fur+ns ne.yn+tkd FkCility 1714 lHc+tMet <br /> af/Iya1611rsrtf ffsni fH+d red gsfMAW Die IAr FNII11Y GWRIvl Was"PreEly Watsih0104■Iw om as 111f a,wwrl wrlhsn rrMklwlca la Ifs Gsaghtel Mhs1!PrdlMf <br /> and t Assl e n h w,1i1f tkfriallR.I dedtrr WM%l P"ff r u1 pa1 Uq that the 1,A ino tutna <br /> a CleelnTech Environmental Inc, ,r f <br /> _ 2581 S.Sunland Ave. , ,r` <br /> I <br /> Fr69n4. CA 93 25 DRLVE 5 NAME -TYPE flR PRINT FULL NAME <br /> ! [L EPA ID o:CAL000968135 <br /> z <br /> Trude, Unit ID Na, <br /> SIGNATURE GATE <br /> The C1leltked Dox is the doslgnated riKycling tacll p <br /> d Southwest Processor ❑ticrltage Envima *ntld ❑CleanWh ErrAMnrnental <br /> O Roadrunner GWI.IFI-C. 5820 F,1afpR Ad. <br /> IG36 tndustrlalCf.rllei or. ON FUndinl Bhrd. 28�LMMY Road Irwlndate.CA 91746 <br /> Las Vegas NY$9115 tifernf CL921658 EPA#CALfl0U33W <br /> _ EM*NVRLX'KkW`+27 EPA iC.11W0-336437 EPA#yrt.A2$5128 <br /> i 50��3Q1}3366 EFA#112tiUB1?TAM Ph#6M211 2-72M <br /> M*52"34167 <br />