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leanTech SERVICE WORK m= ORDER Environmental Inc. 195319 2581 S. Sunland Ave. • Fresno, CA 93725 Phone: 800-531-9683 WASTE RECYCLING RECEIPT Name-. .Ta Con C'+1'0 -- Customer Purchase order R Address: 1 1€ Safes Representative _ City, State, Zip: Lo,j t C Phone#: EPA I Q * 14 �0t Federal Manifest 4: QUANTITY UNITS U-S.DOT DESCRIPTION CHARGE GAL. USED OIL--NON RCRA HAZARDOUS WASTE, LIQUI l7 --- -- -- CA WASTE CODE 221 GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 134 I OILY WATER FROM USED PARTS WASH SOLUTION— I GAL i NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 LU DRUM(S) DRAINED USED OIL AND GAS FILTERS — — — W � i1'lcr►'t � 43 TOTAL �• (�� UJ Tne above used oil is %Lubricating oil_ I Industrial oil 61.1 ACCOUNT STATUS: J C.O.O. ( }OPEN ACCOUNT If open Account-payment is due net 30 days or a finance charge of 1.5% CL per month will apply. GENERATOR'S NOTIFICATION AIG CERTIftGATIOW Any v5ed W that the traffsparter rec ivts born the generates wit be transpo.tee to a cseiifiec usad di!reGycrtgg M,oily Inst is U lawfully operating In accordance with a harartlous waste acuities pe*m 1 issue:oursuanr to the Federal Act I herghy declare that the nntents of tells zoris(Qmmnl are Cully and W aeeuatel;r aescr'bed abbe by the proper 00T shipping name and are cfasSified,paOarged.marked,and labeled and are is ali npecrs in pr::per condWort fnr Iranspan by n-0 T M mrtdards.AtI relevant Information regarding known or suspected hazards associated with!his waste has teen disclosed The uustofrer agrees to pay ieasonabie ros-and attorney 0 fees incur ed m the collection of this obligation.Venue f;r purposes of this obligation shall pe in LPs Ange'es County !rig-city that the waste r tm rizanv^statemer,i idegU,ed w 4a 1— GR 26227(a)(a I am a la ge quantity generator;or(6)(H I am a sma:gJanttty generalflr!is true,1 also ackncratedge that!have raao and agree to tre terins on;his•:orm ucih iforil arid back.Signer guarantees the pay nient of Claan7a;6 i nvoicas ii accordance will-,the standard to+ms 3f Net 313 days.If a Purchase UTder is ncI isaved.she�fi'ti;1:1 .'aJ;t'wiz116'the ruerx performed guarantees that arrr Invoices p res®nled will he paid promptly.Prompt payment Is defined as payment in acoornanca with ClaanTscll stardaro se :;01'.r�.C Jays. Invoice payment is not cdmingent r.Pon Payment by a fhfrd party.Interest or,past dee aceounts will q,,,,tar at the rate at 1.5%per month until paid in fuh WASTE MATEREALS WHICH ARE 0ISGOVEREDTO BE PON-GONfGRMINEl WILL RE St1RdECT TO AOGiTIONAL CHARGE 1 TYPE OR PRINT FULL NAME N L1RE I DATE I liereby certily(hat I have read and han ifa autkrily to bind the above listed rgeneratpr to the terms toLiU of bolh the fsant and-back of this toric 5:atc Lam,izqusres this 60th iiia venerator and Transporter keep this form on file for a minimum of(3)years. I hereL: ortify fiat all rntsyma'icj r i this and Oi attached dFxwlttdnts tr,ie acid nCC;iral' dw5 riptfcns of the waste including that!he waste is sagregatad ants is not comingled wilt other waslp sl'earrs..As �.�as 1,inerator.I acxnore4edge the!ou;sJe EPA t7 41 is a:tisa 711e waste sirearn limed shove CGMPI;es LenT the waste?t^rile on record tnf the"sigllated raclJRy This document serves as written varlficatfdn that the waste streamisl descrlption and eoastltaents found above are unchanged per the Facility Generator Wasta Prefile Worksheet and also acts as the annual written verification ter the Generator Waste Profile Warltsheet at itiese waste streams.I declare urwer penally of perjury that the faregoing is true and correct. [C CleanTech Environmental Inc. LU 2581 S. Suniand Ave. // Cs M- p Fresno, CA 93725 DR 5 NAME-TYPE OR PRINT FULL NAME vers EPA 10#:CALOOD368136 Truck. Unit IO No. 1 — ��- _-z S ..----- SIGNATURL DATE The checked box is the designated recycling facility Z H A Roadrunner Glycol,Inc. El Southwest Processors L7 Heritage Environmental antech Environmental U 4636 Industrial Center Dr, 4120 Banditti Blvd. Services LLC 5820 Martin Rd. g U Las Vegas,NV 89115 Vernon,CA 90058 284 Fast Storev Road Irwindale.CA 91108 M U LCL LPA#NVROOOD88427 EPA#UAL921646037 Coolidge,AZ 85128 EPA#CAL0C�i33i7�+53 !� rL Ph#7021379-7179 Ph Ot 8001960.3366 EPA#AZD081705402 Ph f 626i6 12-7200 Ph#5201723-4167