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1`'.5! -= Cie a" n Te ch ORDER Environmental Inc. 19 19 9 at 2581 S. Sunland Ave. a Fresno, CA 93725 p 11 Phone:800-531-9683 WASTE RECYCLING RECEIPT N aril e: Customer Purchase Order ff Address: _ Sales Representative ,_- City, Stale. Zip: --. Phone 4, EPA IDA: A '0002A 11 1 Federal Manifest It: QUANTITY UNITS U.S.DOT DESCRiPTION CHARGE } USED OIL-NON RCRA HAZARDOUS WASTE,LiQUID GAL. USED WASTE CODE 221 '- GAL. USED ANTI-FREEZE-NON RCRA HAZARDOUS WASTE;,LIQUID CA WASTE CODE 134 QTLY WATER FRAM USED PARTS WASH SOLUTION- GAL. NON-RCRA HAZARDOUS WASTE,LIQUID, OA WASTE CODE 134 } Cr - DRUM(S) DRAINED USED OIL AND GAS FILTERS to _. TOTAL O 7. WThg Above used Oil 19 °t Lubricating od- _%Industrial 011 ACCOUNT STATUS; { )C.O.D. ( )OPEN ACCOUNT Ira ern Account- 11 W i! P payment Is due not 30 days or a finance charge 01 T.S'f. 1 IL per month will apply. Q d GENERATOR'S ROTIrICATION AND CERTIFICATION:Any used ail thal the transporter receives from the generalbF*IN be transgdrted to a cernfied used dY ra[ychng facility That is U rawfully operat,rg m accordance wilt a halardaus waste lacAlres permit Issued pu,suanl to the rbderal Act.1 hereby declare that the Cements el m s con51gomerll are fully,wild NJ accurately descntxd above by the proper vor shipping name and are GLtssilied,packaged,marked,and 411ete11 and are in,ail aspects in proper condition for iranspr rl by Do T M standards All relevanl information regarding known or suspecled hoards assdclaled wllh this wasle has been disclosed.The CUSICnIer 3greea td pay(03-till CdSS and attorney - O fee4 incurred in the CD4fectl0n of this Dbugall0n Venue for purpOaEs at this nhlnoahpn Shall b9{p L94 Angeles County, I The Idol IN Waste inInIMIZtlion Statelrient Identified in 40 t - CFR 213227lall if I am a la roe 4uardrty,genenalor)or(b1 Iii I am a Small quail nay geI'M10f)15 hue.I 319D acknOwladga that 1 hays read and agree to the Clare On mle form bath irDnt _ and back Signer quaranlees the payment of CleanTach rnwlces in accprdancs WHIT,rhe sla{+dard lams vl Nol JO days.Ila Purchase Order is na Testred.the emplbyaa author Irrnq the work performed puaranthat rees any inonicm presented wlil be paid promptly Prom-payment n defined as payment in accordance onih CleanTech standard terms of net 30 days. .� Invoice paymerf i5 n01 contingent open payment by a thud eerie farerest on pair due accounls will be Charged at the rale of t.5`.per month until paid Pi lull,WASTE MATERIALS WHICH ARE DISCOVERED TO DE NONCONFORMING WILL BE SUBJECT TO AODITIDNAL CHARGES, 1 'rIMf1 TYPE ON PRINT FULL NAME �810URE I hereby cerldv Thal I haws roadam have the auihority to bind 1110 blwM listed pedefalor 10 the Terms found on both IM lrunl and hick Of Oil form Stale LAv++equires that both ,1 A the Generaldr and}ranspurler keep lhie term on Ide lar a rnlnlmum dr(OI years r nareby dorUN that all intarmaiien in fr rs and all atyghad deco tterits contain true and accurate descriptions of the wasle including that the wade is segregated and It not comingred wirh olher waste SIMMS-Aa the GeaeralDr.I acknawledga That aur site EPA 101 15 Mllve Thin waste sireanl ilsted above complies with the Wasir Profile on record for the dsrgnaled Faerhly.Thla docemanl aareea so written naneallaa that the walla efreem(e)deacHpttdn r and ianstitueeis sound above are unchshgad pee the Facility Reiraraldr malts Prdllla warkshsst ane wish acla as the annual wrtNaa verification for the Generator Waste prellla Workah"t of these waste slr ismil i 6tylare under penalty of prrlury mal the forcgoinq Is Rua and Correct T CleanTech Environmental Inc. LU r� 2581 S.Sunland Ave. o Fresno. CA 93725 i r� ZEPA ID#:CAL000368136 DRIVER''$NAME-TYPE OR PRINT FULL NAME Truck, Unit I D No. z 1 SIGNATURE DATE 00 The checked box is the designated recycling facility } ❑Roadrunner Glycol,Inc. ❑Southwest Processors ❑Herl-tage Environmental4CIleantooI 4636 Industrial Center Dr. 4120 Bandlni 61vd. Services LLC Environmental J 5820 Martin Rd. � y C] Las Vegas.NV 89115 Vernon,CA 90058 284 Easi Storey Road+ c W EPA 1 NVROD0088427 EPA#CAL921646037 284COOE East to ey Ro Irwindale,CA 91706 28 CL X Ph i 7021379.7179 Ph N B00✓900-3366 EPA 0 AZD081705402 EPA I CA1_000330453 � Ph 0 5201723-4167 Ph*626M12.7200 ?� .vH