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-= Cie a" n Te ch ORDER Environmental Inc. 19 19 9 at 2581 S. Sunland Ave. a Fresno, CA 93725 p 11 Phone:800-531-9683 WASTE RECYCLING RECEIPT N aril e: Customer Purchase Order ff Address: _ Sales Representative ,_- City, Stale. Zip: --. Phone 4, EPA ID A: A '0002A 11 1 Federal Manifest It: QUANTITY UNITS U.S.DOT DESCRiPTION CHARGE } USED OIL-NON RCRA HAZARDOUS WASTE,LiQUID GAL. USED WASTE CODE 221 '- GAL. USED ANTI-FREEZE-NON RCRA HAZARDOUS WASTE;,LIQUID CA WASTE CODE 134 OILY WATER FRAM USED PARTS WASH SOLUTION- GAL. NON-RCRA HAZARDOUS WASTE,LIQUID, CA WASTE CODE 134 } Cr - DRUM(S) DRAINED USED OIL AND GAS FILTERS to _. TOTAL O 7. WThg Above used Oil 19 °k Lubricating od- _%Industrial 011 ACCOUNT STATUS; { )C.O.D. ( )OPEN ACCOUNT Ira ern Account- 11 W i! P payment Is due not 30 days or a finance charge 01 T.S'f. 1 IL per month will apply. Qd GENERATOR'S ROTIrICATION AND CERTIFICATION:Any used ail thal the transporter receives from the generalbF*IN be transgdrted to a cernfied used dY ra[ychng facility That is U rawfully operat,rg m accordance wilt a halardaus waste lacAlres permit Issued pu,suanl to the rbderal Act.l hereby declare that the Cements el lhrs con51gomerll are fully,wild NJ accurately descntaed above by the proper vor shipping name and are GLtssilied,packaged,marked,and 411ete11 and are in,ail aspects in proper condition for iraii%N?l by Do T M standards All relevanl information regarding known or suspecled hoards assdclaled wllh this wasle has been disclosed.The CUSICnter 3greda td pay reasdnabre CdSS and attorney - O ree4 incurred in the CD4fectl0n of this Dbugallhn Venut for purpOaEs at this nhlnoahpn Shall b9{p L94 Angeles County, I The Idol IN Waste inInIMIZtlion Statelrient Identified in 40 t - CFR 26227laIl if I am a la roe 4uardrty,genenalor)or(b1(If I am a Small quail nay geI'M10f)15 hue.I 319D ackndwladga that 1 haye read and agtat to the Clare On mle form bath irDnt _ and back Signer quaranlees the payment of CleanTach rnwlces in accprdancs WHIT,the sla{+dard lams vl N01 JO days.I l a Purchase Order is na%5"d.the emplbyaa author trr work performed puaranrees that any inonicm presented wlil be paid promptly Prom-payment n defined as paymentnq the in accordance onth CleanTech standard terms of net 30 days. .� Invoice paymerf i5 n01 contingent open payment by a thud eerie farerest on pair due accounls will be Charged at the rale of t.5`.per month until paid Pi lull,WASTE MATERIALS WHICH ARE DISCOVERED TO 01 NONCONFORMING WILL BE SUBJECT TO ADDITIONAL CHARGES, 1 'rIMf} TYPE ON PRINT FULL NAME �810URE I hereby cerldv Thal I haws road am have the aulhority to bind the blwM listed pedefalor 10 the lerms found on both IN lrunl and hick Of Oil form Stale LAv++equires that both ,1 A the Generaldr and}ranspurler keep lhie term on tilt ldr a rnlnlmum dr(01 years r nareby dorUN that all intarmafien in fr rs and all atyghad da[u tterits contain true and accurate descriptions of the wasle including that the wade is segregated and Is not comingred wirh olher waste SIMMS-Aa the GeaeralDr.I acknawledga That our site EPA 10 0 15 Mllve Thin waste stream iisted above complies with the Wasir Profile on record for the dsrgnaled Fadrhly.Thla docemanl wins so written naneallaa that the walla slreem(s)deacHptton r and ianstituenla sound above are unchahgad pee his Facility Reituraldr 1Vuts Prdllls warkshsat and wish acls as the annual wrtNad verification for the Generator Waste rarellle Workah"t of these waste slr ismil i dd[Iare under penalty of prrlury mar the forcgoinq Is true and Correct T CleanTech Environmental Inc. LU r� 2581 S.Sunland Ave. o Fresno. CA 93725 i r� ZEPA ID#:CAL000368136 DRIVER''$NAME-TYPE OR PRINT FULL NAME Truck, Unit I D No. z 1 SIGNATURE DATE 00 The checked box is the designated recycling facility } ❑Roadrunner Glycol,Inc. ❑Southwest Processors ❑Herl-tage Environmental4CIleantooI 4636 Industrial Center Dr. d120 Bandlni 61vd. Services kLC Environmental J 5820 Martin Rd. � y C] Las Vegas.NV 89115 Vernon,CA 90058 284 Easi Storey Road+ c W EPA 1 NVROD0088427 EPA#CAL921646037 284COO E East to ey Ro Irwindale,CA 91706 28 a. X Ph i 7021379.7179 Ph N B00M0-3366 EPA 0 AZD081705402 EPA I CA1_000330453 Ph 0 520R23-4167 Ph*626M12.7200 ?� .vH