COMPLIANCE INFO_2026 - Laserfiche WebLink

Home Browse Search

..,_ � -- _ ._...n anti]�f► - ' i — SERVICE WORK Tech ORDER Environmental Inc. 198370 2581 S. Sunland Ave. a Fresno, CA 93725 Phone:800-531-9883 WASTE RECYCLING RECEIPT f Name: Customer Purchase Order# '•' Address: C n Sales Representative ` City, State,Zip: r t r Phone#: EPA ID Federal Manifest#: ❑ Gr�lo �t/ r QUANTITY UNITS U.S.DOT DESCRIPTION CHARGE Com:• - GAL. USED OIL—NON RCRA HAZARDOUS WASTE,LIQUID CA WASTE CODE 221 GAL USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE,LIQUID i CA WASTE CODE 134 cc OILY WATER FROM USED PARTS WASH SOLUTION— C:: D ti NON-RCRA HAZARDOUS WASTE,LIQUID. CA WASTE COME:134 � l LU ,s LU DRUM(S) DRAINED USED OIL AND GAS FILTERS n W } W TQTAL , i} C LLUThe above used oil is %Lubricating oil %Industrial oil L7 i— �} WACCOUNT STATUS: ( ]C.O.D. l 1 OPEN ACCOUNT It open Account-payment Is due net 3,0 days ora finance Charge of 1.5% Roil [� OIL per month will apply, DGENERATOR'S NOTIFICATION AND CERTIFICATION:Wry used nil that the transposer recelvea from the generalor will be Iransponed to a terrified usedoil recycling radllty that is C1 lawfully operating in accordance with a haNrdous waste facilllles parmil issued pursuant to the Federal Act.I hereby declare that the wf4errls oi this consignment are luny and accurately ds%rlwo above by the proper DOT Shipping name and are classdr@d,packaged,marked,ancts in proper condrtion for transport labeled and are in all aspe M standards.Air relevant information regarding known or suspected hazards assoolated with this waste has been disclosed.The CuslDmeT agrees to pay masanaale cast and attorney '• fees incurred in the CDII@CtiOn of this obligation.Venue for purposes of IhK obligation shall be In Los Angeles County.I earthy that the waste rrdninrl3aiion statamem idonlihed rn 4,0 '•.' CFR 28227;a}(if I am a large quantity generator)or(b)Elf I am a small'quantity generalor)Is true.I also acknowledge that l have Toad and agree to the terms on this form Min front and back.Signer guarantees the payment df Cleaniech Invoices In accordance vnth the standard terms of Ne!30 days.If a Purchase order is riot Issued,the employee authorizing the work performed guaramees Ihat any invoices presented will De pald promptly.Prompt payment Is defined as payment in accordance vrhh CleanTech standard terms of net 30 days. Invoice payment rs not contingent upon payment by a third party.w6rest on past due accounts will be Charged at the rete of 1.5%pet month Until Mid in full.WASTE 1AATERJALS i WHICH ARE DISCOVERED 70 BE NOWCONFORMING WILL BE SU&JECT TO ADDITIONAL CHARGES. TYPE OR PRINT Pt1LL NAME7 SIGNATURE � _• I hereby cerlity that I NO read and have the alltbDriiy to bind the above listed generator Iq the terms found Dn both the frgmt and back of this farts,Stale Law requires that win the Generator and Transporter keep this form On file for a minimum of(3l'yearn I hereby carlity that all information in this and all attached documents contain true and aCCurate . descrrplions off"waste including that the waste is segregated and is not cominpled with other waste Streams.As the Generator,I acknowledge that our Site EPA ID 1 is active.The • waste strOant listed above complies with the Waste Profile an record Tor the designated Facility.Tkls document serves as wrtaan vaH kptlgh that the wish steam(s)description and CDhsillaorda found above are unchanged per the Facility Generator Waste Profile Worksheel and also ads as Ina anaial written verificattotl for the Generator Wade Fichte r Worksheet oI that@ iisle streams.I declare under penalty di perjury that the TO100irig is true and correct - CleanTech Environmental Inc. ' r 2581 S.Sunland Ave, C a Fresno, CA 93725 DRIVER'S NAME•TYPE PRINT FULL NAME EPA ID*:CAL000368136 z IM Truck, Unit ID No. SIG V URE DAT The checked box Is the designated recycling facikity � Envi r3k>_ �• . ❑Roadrunner Glycal,Inc. ❑Southwest PrDDessors ❑Heritage Environmental ❑Clttantech ronmental 4fi36 Industrial Center Dr. 4120 Bandini Blvd. Services LLC 5820 A+lartin Rd. Las Vegas,IAV 89115 Vernon,CA 90058 284 East Storey Road Irwindale,CA 91706 c Q W EPA#NYRODD089427 EPA#CAL9211CALM M53 Coolidge,AZ 85128 EPA#CALM53 LU Ph 4 7071379-7179 Ph 1800190M366 EPA#AZD081705402 Ph#62012-72fl0 Ph#520f723-4167