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O ■ <br /> Coro SERVICE WORK 11) <br /> Corporate Office 0453 ORDER <br /> TechEPA IMa in Road* Irwin <br /> 580 Martin Road• Irwindale, CA 91706 <br /> Phone, 1-800-531-9683 $ 4 <br /> . www.r-leanlechenv.com <br /> SERVICE WORK ORDER <br /> SALES OFFICE: J Fresno 0 Irwindale ❑ Newark �j Sacramento ❑ San Diego 0 <br /> Name Customer Purchase Order# <br /> Address C „ ;. Sales Representative <br /> City State Zip cj Phone# ,r n.73 _q <br /> EPA ID �y Ck#ICOD <br /> Ik NON-RCRAIRCRA WASTE <br /> PART# DESCRIPTION MANIFEST# QTY. UNIT PRICE SUB-TOTAL <br /> 23523!55 ABSORBENT MATERIALS (55 GAL.) <br /> � 929DooAC AEROSOL CANS (55 GAL.) <br /> d 9290000F BRAKE FLUID (55 GAL.] <br /> 929NO13S BRAKE SHAVINGS (30-GAL.) <br /> IL 7 8NREGT EMPTY GASTANKS [55 GAL.} <br /> 9DO0155 MIXED FUELS(GAS IDIESEL) 155 GAL•} <br /> 4r 0 9ORS005 OILY RAGS {55 GAL.} <br /> a 90SLO55 OILY SLUDGE {55 GAL.} <br /> 08 9FD0355 PAINTED RELATED MATERIAL-LIQUID (55 GAL.) <br /> z 22211055 USER OIL FILTERS-METAL(NOT DRAINED) (55 GAL.) <br /> LL) 28523055 USED OIL FILTERS•PAPI R (55 GAL-) <br /> ' 22211155 USED OIL FILTERS-CRUSHED 155 GAL.) <br /> MRCRA MANIFEST FEE-RCRAwASTE <br /> MNRCRA MANIFESTFEE-NDN-RCRAWASTELU N r <br /> IU Al <br /> Any Nan-Conforrhin9 Waste Subfecl to Additional Charges. F <br /> G EMPTY REPLACEMENT DRUMS <br /> LLI I—S 55aTFF OPEN TOP{55 GAL.)DRUM-REPLACEMENT DRUM FOR USED OIL FILTERS No Charge 0.00 <br /> d 550TW6 OPEN TOP(55 GAL.)DRUM-REPLACEMENT DRUM FOR WASTES <br /> O 5scTWB CLOSED TOP{55 GAL.}DRUM-REPLACEMENT OF WASTE � <br /> PARTS WASHER SERVICE yy`i 1 <br /> WASHER <br /> BRAKE RENTAL UNIT(12-GAL. PORTABLE AIR OPERATED <br /> 12BWflS tl ;i f <br /> 30PWRS PARTSWA5HERflENTALUNIT(30GAL.)DRUM MOUNT <br /> -1SCS POVyERSTAR PARTSINASHEA SERVICE-CUSTOMER OWNED MACHINE <br /> SCS- <br /> 4 .Y <br /> PSC- POWERSTAR SOLUTION <br /> f 0 MIANPw PARTS WASHER OIL WATER MANIFESTI PRODUCTS <br /> • U CCGRN55 CLEAN COOL"GRfff`N 50150 HEAVY DUTY 55 GAL. <br /> + aj CCGLD55 CLEAN COOL GOLD RECYCLED 50150 EXTENDED UFE,UNIVERSAL 55 GAL. <br /> 91. UAP UNIVERSAL ABSORBENT PADS- fOOPADS PER RUNDLE <br /> UASt13D UNIVERSAL SOCK- 30 PER PACK <br /> As the Generator,I acknowledge Itiat our site EPA ID i is active and rf needed CleanTech to sign as agent an the Generator Waste Profile Worksheet for this <br /> wastestrearn{sy.This docurnenl serves as a wn[ten verification Ilial the waste stream(s)descriptions and constituents found above are unchanged per <br /> Generator Waste Pref!le Worksheet and also as the annual written verihration for the generator waste stream prefile worksheet of These waste .N <br /> ttre Facility <br /> - streams. declare Linder the penalty of edury that the foregoing is true and Correct. <br /> Custom <br /> er Print Name: <br /> •. Customer Signature: .' Date, i <br /> -4 Drive rlServieed By: -�-- Date- <br />