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Corporate Office SERVICE WORK <br /> j17QC EPA ID#: CAL000330453 ORDER <br /> J 5820 Martin Road a Irwindale, CA 917x6 <br /> Environmental Inc. - Phone: 1-800-531-9683 3 <br /> 6. www.cleantechenv.com <br /> 739 - <br /> SERVICE WORK ORDER <br /> r SALES OFFICE: U Fresno 3 Irwindale ❑ Newark J Sacramento ❑ San Diego � <br /> qAd, <br /> me Lfiv--% I tavwl tianitS Ni►1!■., t Customer Purchase Order # <br /> ress 1+,r ,ts 1i Th[,rlorl Rn Sales Representative t;5 0 <br /> 0y State zip Lod CA 96242 Phone# ��M <br /> A ID# t �.Rirfx1YA11 74 Ck#/COD <br /> NON-RCRA/RCRA WASTE <br /> RT# DESCRIPTION MANIFEST# OTY. UNIT PRICE SUB-TOTAL <br /> t= 23523155 ABSORBENT MATERIALS (55 GAL.) <br /> J 929000AC AER050L CANS (55 GAL.) <br /> Q 929000BF BRAKE FLUID (55 GAL.) <br /> 0 929NO13S $RAKE SHAVINGS (30-GAL.) <br /> in <br /> HNREGrT EMPTY GASTANKS (55 GAL.) <br /> -M A ❑ 9DO0155 MIXED FUELS(GAS l DIESEL) (55 GAL.) <br /> 0 ❑ 9ORS005 OILY RAGS (55 GAL.) <br /> �7�/ C� r22211055 <br /> 55 OILY SLUDGE (55 GAL.) <br /> 5 PAINTED RELATED MATERIAL-LIOUID (55 GAL.) <br /> WUSED OIL ALTERS-METAL[NOT DRAINED) (35GAL.)W' 55 USED OIL FILTERS-PAPER (55 GAL) a ll V Z 55 USED OIL ALTERS-CRUSHED (55 GAL.) xko <br /> > MRCRA MANIFEST FEE-RCRA WASTE <br /> LU N MNRCRA MANIFEST FEE-NOM-RCRAWASTE y ■a4( <br /> zLU <br /> w ! <br /> T <br /> UCC_ 'Any Non-Conforming Wasle Subject la Additional Charges. ' <br /> # EMPTY REPLACYEMIENT DRUMS <br /> ++ > Z 55OTFF OPEN TOP(55 GAL.)DRUM•REPLACEMENT DRUM FOR USED OlL FALTERS NO Charge goo <br /> Q SSOTWB OPEN TOP(55 GAL.)DRUM-REPLACEMENT DRUM FOR WASTES <br /> Cn J <br /> ❑ 55C'TWS CLOSEDTOP(55 GAL.)DRUM-REPLACEMENT OF WASTE !:Jo f f I <br /> 0 PARTS WASHEAMRM <br /> ' • U <br /> Z 12SWRS BRAKE WASHER RENTAL UNIT(12-GAL.)PORTABLE AIR OPERATED <br /> - W 3OPWRS PARTS WASHER RENTAL UNIT(30-GAL.)DRUM MOUNT <br /> SCS- SC5 POWERSTAR PARTS WASHER SERVICE-CUSTOMER OWNED MACHINE <br /> Q <br /> �! Z PSG POWERSTAR SOLUTION <br /> ❑ MANPW PARTS WASHER OIL WATER MANIFESTS <br /> J PRODUCTS <br /> C) CCGRN55 CLEAN COOL-GREEN 50 150 HEAVY DUTY 55 GAL. <br /> W CCGLD55 CLEAN COOL GOLD RECYCLED 50150 EXTENDED LIFE.UNIVERSAL 55 GAL. <br /> a - <br /> cn UAP100 UNIVERSAL ABSORBENT PADS 108 PADS PER SUNDLf <br /> UAS030 I UNIVERSAL SOCK• 30 PER PACK( <br /> As the Generator.I acknowledge that our site EPA 10►is active and rf needed CleanTech to Sion as agent on the Generator Waste Profile Worksheel IDT this <br /> wastestrearn(s).This document serves as a writlen venficatlan that the waste stream(s)descriptions and conspluents found above ars unchanged per t <br /> the Facility Generator Waste Profile Worksheet and also as the annual written verlfication for the generator waste stream profile worksheet of these waste <br /> streams.I declare under the penalty Of perjury that the foregoing Is true and correel. <br /> i <br /> Customer Print Name: <br /> _ I <br /> `R Customer Signature_ `'`oj= f D Dole, <br /> ` ) Driver tServiced ^A <br /> °"" Q <br /> r <br />