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S It1'i0" 4`'UKh <br /> le a n Te ch ORDER <br /> Environmental Inc. 288747 r • <br /> r 5824 Martin Road, Irwindale. CA 91706 <br /> look Phone; 626-812-7204 +r F! <br /> ` 04# WASTE RECYCLING RECEIPT <br /> Mame; �' customer Purchase order p 0 <br /> Address: Sales Representative <br /> t t� Phone #: <br /> City, State,Zip, r 'f ' 1 ��� -- <br /> 4 /) `1 1 f I 11 , Federal Manifest `_ --- — <br /> EPA 1D 4: �- �----- 0 <br /> CHARGE <br /> �•' <br /> d -- QUANTITY UNITS U.S.DOT QE5CR1PTIaN D F F <br /> r e GAL. USED OIL—NON RCRA HAZARDOUS WASTE, LIQUI . <br /> r r 1 r CA WASTE CODE 221 <br /> GAL. USED ANTI-FREEZE—NON RCRA HA7-ARDQUS WASTE,LIQUID <br /> CA WASTE CODE 134 . <br /> 0 OILY WATER FROM USED PARTS WASH SOLUTION— <br /> GAL. NON-RCRA HAZARDOUS WASTE,LIOUID, GA WAST-E�-C.LOrD-E^1-34 <br /> tt .11 <br /> UJ JL DRUMS) DRAINED USED OIL AND GAS FILTERS <br /> Q <br /> I TOTAL f t i•k <br /> E Q fe+ <br /> W % dusirlsl 011 <br /> # k F— 9S Lubricating op Ina nnerlt is dug rNl 7a deys or n iinnncn ch�ryrF 01 1.5ti . <br /> W The above used oil Is��-— <br /> p p { �OPEN gCCdIJNT Ir open Account-p Y �— <br /> r # a ACCOUNT STATUS' 1 I G- - -- <br /> f O par rnnnih will apRIY• iter recehroa r,,Ihr rnerAtdr Ms Gr tranapeAle4 1p+crrtrhad used dl rrrYCknq I di° <br /> ��~-� r SdndJian . <br /> U OENERATOR'S NOTIFICATIUTA AMD CERTIFICATION; Any used nR that the rranapo y <br /> in acr:nrdsnc!with a liararddus wa9te tacdltles permit tgsued nurcridnl t0 the Federal At! I hrrehr derrrre that the rMtlfnla s ru , <br /> W ty Ina!is lawfully operahnq y in name and ars clj.%III O n� aged marked and{-W h and ire is to led With m grape <br /> W Mont are fully and aCFurntet d05eubee above by the proper ilaim q <br /> hl hway sGGntdlnp IUapTQondt7Earltosl 2ndtnnn[ney nle5 111ii0i'llallar �5 hhgown rihnn�VN ue torr pnruns+4tn}rink ohlrlgate i+t,rrlll De in <br /> for[ransparl by q rhos to pay a accart-lin to Mill, <br /> disclosed The cus101nar 8p cis con fur hal ro <br /> perjury tliitlhrfostati plstrueandtnrtu llter"ColltrdIDA, heContents(itthittons9+lntairtAleltrhyandrirrlratarr sari <br /> LOS Angeles�Dunty rlecWre under p I y tit Atka rd marked.and 0911011*lcatd.Add Ar!n All nspr[I�lit preps nment conform to lernia of the <br /> above by Ina proper shipptn¢nAmd.and are ifs€S ed,p p All rel <br /> tions al <br /> the wall! <br /> Leola an0 nAhonal g0vernmenral regtditlons li export shipinan!and 1 Ani the Prinmry Expdnar.I roin rtrN thCl R at the contend o his <br /> 7 271A <br /> f' fnached EPA Ackntiwlydgmedl Of Consent I cerlltY Thal late wafts minanieatr A+le hA fbsl °'lull,sed,OI olio+Mnowkdge limlttett4vsrrad a,1d ADM 101 Nrmston <br /> am a <br /> hod <br /> E A Ackni ed meaor)o Ione I Iterahy nerhly Iltnl stl ntrormallolit idol <br /> d In this And all aftaChCd drxumenlx Cdntarn hue And acrtnata°asci Ip <br /> aviol m}Oimandn regarding known Or sit petted hatard8 ssanciatad whit the ' <br /> t Prom t nwnl4ldfllMdax Wyfdentrn,xrot dai>ce <br /> UHl Ionf o both Iran)and neck Slgnei g0atanleef the 0011,011t C1esnTec11 m dices in pccdrdrncr pitid Ino standard ietm5 pr Nal 3O II t piuchAsa°Argo ie nil aalr <br /> Rif <br /> # men!is it0![Anna enl upon l.rret+nt by a Ihudps rty [nines[n+,p.rtr due�ctdunlawlll bt tturgrd at Ihr Nlr 41 <br /> the employaa puthoriring the work to be poi IdrOICO aym nit is that any Vnvwcna preaanlyd l byill be paid p a nBE p Fry t F <br /> I.4 <br /> will Gleanierh standard terms of 3O days Invoice pay 41 [ 1 <br /> 1.59 pea mbntn until pall WASTE!AA ERIALS WHICH ARE UI8COVEREg TO A£NON•CONFORMINO WILL BE SUBJECT TO ADDITIONAL CHAR <br /> a#*!1 ,�•f4 �*�i3� *NATURE DATE <br /> tr1 srelGr to the letme On the ream¢¢fids OF Ihia form. <br /> i ryPE OR PRINT FULL NAME <br /> oerttly that I have read and have It a authority to bind the shove hard pr+ti <br /> 1 hereby a this t3eceipt�ilt of LadFn9 on hlf for no her than t3}yesrr <br /> Stato Law raqutres that YOU Ice lo . <br /> a cleanTech Environmental Inc. <br /> W 5820 Martin Road DRIVE g NAtwIE TYPE OR PRINT FULL NAME <br /> Irwindale, CA gt708 �� _ �� � i <br /> EPA 10 #: CAL000330453 � `. Epi <br /> W DAT E 1 <br /> SIGt4ATURE <br /> Truck, Unit ID No• <br /> y 11n iecdlly leintech Environmental <br /> E The checkad box Is the deelgneted recyc q Herllape Environmenl3l Services LLC A82o Martin Rd <br /> Crosby 3 0vertorl 284 East Storey Road <br /> I .t(•Pure WatetwOfl s 1810 W 171h Sireel Coolidge,A7 X5128 Irwindale,CA G17f)8 <br /> 8910 Rochester Ave• Lnnq Beach,CA 90813 EPA F CAL0OM0453 <br /> v Rancho Cucamflnga• EPA I GA0028409019 EPA# 47DOW05402 Ph 0 82&812.1200 <br /> Y CA 91730 Ph 15201723 41$7 <br /> Ph#5BZf432.5445 <br /> Y <br /> a Ph#909/476-9492 <br /> - e <br />