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Sk It1'i0" 4`'UKh <br /> le a n Te ch ORDER <br /> Environmental Inc. 288747 r • <br /> r 5820 Martin Road, Irwindale. CA 91706 <br /> look Phone; 626-812-7200 +r F! <br /> ` 04# WASTE RECYCLING RECEIPT <br /> Name; �' customer Purchase order p 0 <br /> Address: Sales Representative <br /> t t� Phone #: <br /> City, State,Zip, r 'f ' 1 ��� -- <br /> 4 /) 1 1 f I 11 Federal Manifest `_ --- — <br /> EPA 1D#: �- �----- 0 <br /> CHARGE <br /> �•' <br /> d -- QUANTITY UNITS U.S.DOT QE5CR1PTIaN D F F <br /> r e GAL. USED OIL—NON RCRA HAZARDOUS WASTE, LIQUI . <br /> r r 1 r CA WASTE CODE 221 <br /> GAL. USED ANTI-FREEZE—NON RCRA HA7-ARDQUS WASTE,LIQUID <br /> CA WASTE CODE 134 . <br /> 0 OILY WATER FROM USED PARTS WASH SOLUTION— <br /> GAL. NON-RCRA HAZARDOUS WASTE,LIQUID, GA WAST-E�-C.LOrD-E^1-34 <br /> UJ JL DRUMS) DRAINED USED OIL AND GAS FILTERS <br /> Q <br /> I TOTAL f t i•k <br /> p fe+f <br /> W %Indusirlsl Oil <br /> 9S Lubricating op a nnertt Is dug rNl 7a deys or a itnnncn ch�ryrF 01 1.5ti . <br /> W The above used oil Is��-— <br /> p p { �OPEN gCCdIJNT Ir open Account-p Y �— <br /> r # a ACCOUNT STATUS' 1 I G- - -- <br /> f O par rimnnih will apRIY• tier recetvra r,,Ihr rneratOr veh Gr tranapeAle4 1p+crrtrhad used dl rrrYCknq I di° <br /> ��~-� r SdndJian . <br /> U OENERATOR'S NOTIFICATIUTA AMp CERTIFICATION; Any used nR that the rranapo y <br /> in acr:nrdsnc!with a liararddus wa9te tacdltles permit tgsued nurcridnl t0 the Federal At! I hgrehr derrrre that the rMtlfnla s ru , <br /> W ty Ina!is lawfully operahnq y in name and Orr clj.%III O n�•gAa� marked and{abated and ire is to With <br /> m grope <br /> W mont are fully and aCFurnier d05eubee above by the proper ilaim q <br /> hl hway sGGntdlnp IUapTQondt7Earltosl 2ndtnnn[ney nle5 111ii0i'llallar �5 hhgown rihnn�VN ue tort pnruns+4tn}rink ohlrlgate i+t,rrlll De in <br /> for[ransparl by q rhos to pay a accart-tin to Mill, <br /> dlsClnSed The customer 8p cis con fur hal ro <br /> tliit lhr lot ati p is true and tnrtu l hrr"Col l tad IDA, he Contents(it thin toils 9++nuatt Ale tupy and k rtlralarr sari <br /> LOs Angeles�Dunty rlecWre under perjury tit Atka rd marked.and 0911011*lcatd.Add err n All nspr[I�lit preps nment conform to lernia of the <br /> above by Ina proper shippm¢nAmd.and are ifs€S ed,p p All Tel <br /> bons al <br /> the wall! <br /> canla an0 nghonal g0vernmenral regtditlons li export shipinan!and 1 Ani the Prinmry Expdnar.I rr in rtrN th Cl R at the contend o his <br /> f' loathed EPA Acknttwlydgmedl Of Consent I cerllf that late wafts minanieati A+le hA fbsl °'lull,sed,OI olio+Mnowkdge limlttett4vsrsad a,1d ADM 101�Nrmston <br /> am a am E A Ack y ed me3or)o ICo I Iterahy nerhly Iltnl stl ntrormallolit idol <br /> d In this And all aftaChCd drxumenlx cdntdrn hue And acrtnata dafci ry <br /> aviol m}Oimandn regarding known Or sit petted hatard8 ssanCiAEad whit the ' <br /> r t Prom t nwnllldfllMdax Wyfdenttn,x rot daiKe <br /> UHl Ionf o both Iran)and neck Signer gOatAnleef the 0011,011t C1esnTec11 m dices in pccdrdtncr pitllt Ins standard retm5 pr Nat 3O II t pluchaI(°Argo ie nil aalr <br /> ff <br /> # men!is n0! Anhn enl upon l.rret+nt by a Ihud rty In[rrast n+,p.rtr due Actdunlawlll bt tturgrd at Ihr Nlr 41 <br /> It employaa puthor+ring the work to be par IdrOICO Payment <br /> nit is that any Vnvwcna preaanlyd l byill be paid p a nBE p Fry t F <br /> I.4 will Gleanierh standard terms of 3O days InvorCe pry ppsI 41 [ 1 <br /> 1.59�pea mbntn until pall WASTE!AA ERIALS WHICH ARE UI8COVEREg TO A£NON•CONFORMIN+}WILL BE SUBJECT TO ADDITIONAL CHAR <br /> a#*ft ,�•f4 �*�i3� *NATURE DATE <br /> y srelGr to the letmg On the rearree side OF'big form. <br /> i typo OR PRINT FULL NAME <br /> oerttly that I have read and have It a authority to bind the shove hard pr+ti <br /> 1 hereby a this t3eceipt�ilt of LadFn9 on hlf for no W &than t3) resrr <br /> State•Law raqutres that YOU Ice lo . <br /> a cleanTech Environmental Inc. <br /> W 5820 Martin Road DRIVE g NAtwIE TYPE OR PRINT FULL NAME <br /> Irwindale, CA 91708 /k. <br /> _ �� � i <br /> EPA 10 #: CAL000330453 � `. Ep16 <br /> i11 DAT E 1 <br /> SIGtdATURE <br /> Truck, Unit ID No• <br /> y 11n iecdlly leintech Environmental <br /> E The checkad box Is the deergneted recyc q Herllape Environmenl3l Services LLC A82o Martin Rd <br /> Crosby 3 0vertorf 284 East Storey Road <br /> i .t(•Pure WatetwOfl s 1610 W 171h Sireel Coolidge,A7�5128 Irwindale,CA G1�f)8 <br /> 8910 Rochester Ave• Lnnq Beach,CA 90813 EPA F CAL0OM0453 <br /> v Rancho Cucamflnga• EPA I GA0028409t719 EPA# 47DOW05402 Ph 182&812.1200 <br /> Y� CA 917310 Ph 152D1723 41$7 <br /> Ph#5BZf432.5445 <br /> Y <br /> a Ph#909/476-9492 <br /> - e <br />