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Corporate Office SERVICE WORK <br /> EPA ID#: CAL000330453 ORDER <br />' CleanTech 5820 Martin Road • Irwindale, CA 91706 <br /> Phone•. 1:E3.Q0�5. -968 731127 <br /> www.-Tc eantechemr.com <br /> SERVICE WORK ORDER <br /> SALES OFFICE: 0 Fresno ❑ Irwindale ❑ Newark ❑ Sacramento ❑ San Diego <br /> 'Name, 4w 1 f 1 Customer Purchase Order# <br /> Address I S Sales Representative <br /> City State Zip 1 �; ,f r/ Phone# — r 1 <br /> EPA ID # /r i t t l e 7 Ck#/COD <br /> NON-R4ORARCRA WASTE .. <br /> PART# DESCRIPTION MANIFEST# QTY. UNIT PRICE SUB-TOTAL <br /> Q23523155 ABSORBENT MATERIALS (55 GAL.) <br /> 929000AC AEROSOL CANS (55 GAL.) <br /> J <br /> Q 929000BF BRAKE FLUID (55 GAL.) <br /> 929000BS BRAKE SHAVINGS (30-GAL.) <br /> L0 <br /> SNREGT EMPTY GASTANKS (55 GAL.) <br /> Q 9DO0155 MIXED FUELS(GAS/DIESEL) (55 GAL.) <br /> J <br /> 0 9ORS005 OILY RAGS (55 GAL.) <br /> 90SLO55 OILY SLUDGE (55 GAL.) <br /> ca 9F00355 PAINTED RELATED MATERIAL-LIQUID (55 GAL.) <br /> W22211055 USED OIL FILTERS-METAL(NOT DRAINED) (55 GAL.) //' <br /> OUJ 23523055 USED OIL FILTERS-PAPER (55 GAL.) <br /> Z (r3 22211155 USED OIL FILTERS-CRUSHED (55 GAL.) <br /> >. LL.1 MRCRA MANIFEST FEE-RCRA WASTE <br /> W N MNRCRA MANIFEST FEE-NON-RCRA WASTE �r <br /> Z W <br /> ow <br /> LL "Any Non-Conforming Waste Subject to Additional Charges. <br /> LLI EMPTY REPLACEMENT DRUMS f w <br /> a550TFF OPEN TOP(55 GAL.)DRUM-REPLACEMENT DRUM FOR USED OIL FILTERS No Charge 0.00 <br /> yJ 550TWB OPEN TOP(55 GAL.)DRUM.REPLACEMENT DRUM FOR WASTES <br /> 055CTWB CLOSED TOP(55 GAL.)DRUM-REPLACEMENT OF WASTE <br /> 0 <br /> V PARTSVVASHEJ SERVICE, <br /> Q 12BWRS BRAKE WASHER RENTAL UNIT(12-GAL.)PORTABLE AIR OPERATED <br /> W 30PWRS PARTS WASHER RENTAL UNIT(30-GAL.)DRUM MOUNT <br /> J SCS- SCS POWERSTAR PARTS WASHER SERVICE-CUSTOMER OWNED MACHINE <br /> V <br /> Z PSC- POWERSTAR SOLUTION <br /> 0 MANPW PARTS WASHER OIL WATER MANIFEST# <br /> PRODUCTS <br /> (� CCGRN55 CLEAN COOL-GREEN 50/50 HEAVY DUTY (55 GAL.) <br /> W CCGLD55 CLEAN COOL GOLD RECYCLED 50/50 EXTENDED LIFE,UNIVERSAL 55 GAL.) <br /> IL <br /> UAP100 UNIVERSAL ABSORBENT PADS- 100 PADS PER BUNDLE) <br /> UAS030 UNIVERSAL SOCK- 30 PER PACK / f t <br /> As the Generator,I acknowledge that our site EPA ID#is active and if needed CleanTech to sign as agent on the Generator Waste Profile Worksheef fog this <br /> wastestream(s).This document serves as a written verification that the waste stream (s) descriptions and constituents found above are unchanged per <br /> the Facility Generator Waste Profile Worksheet and also as the annual written verification for the generator waste stream profile worksheet of these waste <br /> streams.I declare under the penalty of perjury that the foregoing is true and correct. <br /> Customer Print Name:,,/ <br /> Customer Signature: Date: f C 1 <br /> Driver/Serviced 8 I .� W- <br /> Y' Date:'- � r- <br />