COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

SERVICE WORK e a n "Te ORDER Environmental Inc. 151968 2581 S. Sunland Ave. - Fresno, CA 93725 Phone: 800-531-9683 - WASTE RECYCLING RECEIPT Name: =.-;¢f�rtok7j Customer Purchase Order# Address: J5i5 Liiaa7r D-mp — -. Service Technician F,109 ISE City, State, Zip: Rh3cm CA 416366 Phone #: 663-2l!62-5376II EPA ID #: C AL000308082 Federal Manifest 140711yK QUANTITY UNITS U.S.DOT DESCRIPTION CHARGE: GAL USED OIL- NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 221 t GAL. USED ANTI-FREEZE—NON RCRA HAZARDOUS WASTE, LIQUID CA WASTE CODE 134 a OILY WATER FROM USED PARTS WASH SOLUTION- a GAL. NON-RCRA HAZARDOUS WASTE, LIQUID. CA WASTE CODE 134 6C W Z DRUM(S) DRAINED USED OIL AND GAS FILTERS C7 w }" TOTAL_ LU The above used oil is %Lubricating oil %industrial oil ACCOUNT STATUS: { ) C.O.O. ( ) OPEN ACCOUNT If open Account-payment is due net 30 days or a finance charge of 1.5% Q per month will apply. V GENERATOR'S NOTIFICATION AND CERTIFICATION: Any used Ail that the transporter recelves tram the generator will be transported to a certilred used oil recycling facili- ty that is lawfully operating in accordance with a hazardous waste facllities permit issued pursuant to The Federal Act_ I hereby declare that the contents of this conslgn- meat are fully and arcuraldy described above by the proper shipplog name and are classified,packaged.marked,and labeled and are in all respects in proper condition D for transport by highway according 10 applicable national regulations. All relevant information regarding known or suspected hazards associated with this waste has been f— disclosed. The customer agrees to pay reasonable cost and attorney fees Incurred in the collection of this obligation. Venue for purposes of this obligation shall be in Los Angeles County. I declare under perjury that the foregoing is true and correct. I hereby declare that the corilants of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged,marked,and labeled/placard,and are In all respects in proper condltion for transport according to appli- cable and national governmental regulations. It export shipment and I am the prlmary Exporter, I certify that the contents of this consignment conform to terms of the attached EPA Acknowledgment at Consent. I certify that the waste minimization statement identified in 40 GFR 262,27(a)(if I am a large quantity generator)or(b)(III am a small quantity generator)is true. I hereby certify that all Information fn this and all attached documents contain true and accurate descriptions of the waste, All rei- avant information regarding known or suspected hazards associated with the waste has been disclosed. I also acknowledge that I have read and agree to the terms on this form,both#coni and batik. Signer guarantees the payment CleanTech invoices in accordance with the standard terms of Net 30. If a pumbase order is not issued, the employee authorizing the work to be performed guarantees that any Invoices presented win be paid promptly. Prompt payment is defined as payment in accordance with CleanTech standard terms of 30 days. Invoice payment is not contingent upon payment by a third party. Interest on past due accounts will be charged at the rate of 1.5%per mo th until paid.WASTE MATERIALS WHICH ARE DISCOVERED TO BE HUN-CONFORJMIN WILL BE SUBJECT Tq ADDITIONAL CHARGES. r '" Lr' fIIJ�' 2d� TYPE OR PFUNT FULL NAME SIGMA URE DAVE I hereby certify chat I have read and have the authority to bind the above listed generator to the terms on the reverse side of this term. State Law requires that you keep This Recerpt/Bill of Lading on file for no less than(3)years. a Clean Tech Environmental Inc. a2581 S. Sunfand Aver p Fresno, CA 93725 T1' OR PRINTF ME zEPA ID#.CAL000368136 d Truck, Unit ID No. ! SIGNAT01t DATE IV The checked box is the designated recycling facility U.t 2 u ❑ Roadrunner Glycol, Inc. ❑ Southwest Processors ❑ Heritage Environmental teantectl Environmental 4636 lndustrial Center Dr. 4120 Bandini Blvd. Services LLC 1 5920 Martin Rd, Las Vegas,NV 89115 Vernon,CA 90059 284 East Storey Road Irwindale,CA 91746 W EPA#NVROOOOS8427 EPA#CAL921646037 Coolidge,AZ 85128 EPA#CAL000330453 iL a Pit#702/379-7179 Ph#800/900-3356 EPA#AZD081705402 PH#626812-7200 Ph#520/723-4167