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JAN-18-2009 20:38 FROM: + T0:4683433 P.3/3 <br /> TECHNICHEM Service Receipt I Invoice No. 110889 <br /> _ •.c •'rgrr <br /> cx�oocXxx at,iar]r a lJ.. <br /> 2348 LtrtcoIn Avenue,Heyward.CA 94545't �•'s•.t Authorized Fa�lly: 91$1 rM..;Y+m•e:� <br /> EPA ID t:AR90Q1t31t336 (ItmHmbon+PecyrctivaRcv%ictnrdnebras,l]r PA <br /> III Mit dee Dr Hebron GH 43M E revs 3rd CA <br /> For inquiry or customer service, LnU)301E7de& `Y"c <br /> call(am)652.5x66,(610)M85.6x55 - 4n NO: ChemnTel 1-80P-2 -3924 <br /> Uniform Hwj"ous l 151 I1�FI,E Yrantlparter 09852 Rarf. PI P2008 <br /> Wmtn Manifest No_ Mand69 No. Date: <br /> I'onnrm I1ryt'Ai.�'MJAWkid <br /> Customer/Gana orrat . 'innotht Yowl Generator t;PA 117 it <br /> -19 W,-qt Hirdinp+Wav Customer Account it <br /> Sk�tctwt,CA a4::04 Generator Statue: SCIG GE8t]G 40CFR 281.5) <br /> (17M) 360.15Sk <br /> CE8Gt3 Csrgltcatlon IntNal: ,~��1 <br /> err ---- <br /> Drums Delivered: Meta F iticad.Q <br /> VMW_0- <br /> DOT Description of Hazardous Waste Quantity Waste common Unit Unl1 Amount <br /> Code Desari 'on Price Due <br /> ftQ,WrzSta T.trarltfttros>ttytttu.6.1,UN1 ti97.III CA751 Realdue -� <br /> 0 `Sol Residua X20-D0 R= Ci✓ <br /> RQ Waste Tetrachimosthyteno,6.1,LIN18g7,III ~ c! CA751 adard r`l�p 00 <br /> 7 S lA <br /> FW,Hazardoua Walde,Liquid,n-o,&,9,NA 3082,til • <br /> Petrotsum DMAot9g,Tetrach bene D03 CA134 Wastewater 30 S.t�t).p0 <br /> Non44CRA I-Immieca Waste Liquid S811 Residue <br /> (Patroteum Distluatas,Groan Earth,Ryrtax) CA213 Solid Residue WP 8250,00 <br /> Non-RCRA Hazardous Waste Send . Sbundard 53yu U0 <br /> (Petroleum Distillates,Groan Faith,Rynax) CA213 split QO." S171)00 <br /> Erergy sure"o <br /> o <br /> 'Outstanding $0 <br /> a�a:ars� _ SUBTOTAL <br /> chw* ��' C.O-Q- i volwRe /Other 3Dts , <br /> Check s. Amount $ r aount% <br /> arr <br /> Please Pay C.O.D.* sTOTAL AMOUNT DUE - l <br /> (Mcludrs Crdndirrq !c M.•l rrt� _!tj <br /> By my slgnsturs below, I tartly that the hazardous wastes named above■r9 prop"d02sm941,descrbed aro packaged,and to proper condition for <br /> transportation per appiloebts DOT regulation,that thsss wastes aro stored In undamaged oontsinam that oonWn only the wants as deezibed. I further <br /> adumwledps that I have the 2u ttortty to enter Into the service agreement printed on the raverse,that I understand •V*total amount due will be paid <br /> CA D.unIm crad4 has been extended by TechnlaMem.In WNCh cage,g8ymont as due within 30 days of the date of service. <br /> I may also certify,if indicated as such and by my ini isl above,that the wastes above are generated by a condttlonalby exempt small quantity generator <br /> (CESOG)as deflned In 40 CFR part 281.5,and as suet,per ACCPR part 2881,chess wastes ere not subloCt to any 18rid disposal m5mctian provision <br /> of 40CFR pan 268. Pursuant to HSC Ssc 251130.2(N MK), I also tangy snot i Neve satahlish l a program to reduce the volume or quentlty and <br /> tmdcity of the hazardous waste to the degree as i have determined to be economically predicable, <br /> prtrtt ,� <br /> Cuatorrar dsrtw• �7�� /r � c �i� . .� 5" ���' -�T -��(C � t)ata / <br /> Purousnt to KSC See 25160.2 (a)(2)(C), Tethnicnem hereby confirms that all hamnimn waste above will only be transported to an authO(IZW <br /> hazardous raasts treatment raJ&ly,2W aha hazardm a r+wge may first be bwmDortsd to a storage or transfer faculty In accordance with the applicable <br /> provisions of btu low Technlchem does not taloa 1410 to customer(10MOMted *02119 or athW MaterW. While exercising proper care and safety <br /> precautbrts.I have removed the wastes above from the customer's pmMises and accepted ltte m for tmnsport on the date undersigned below. <br /> atriwieN Blom <br /> Trtumportar 31gmshase arta <br />