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Dip <br /> �7 „�-_.�.���r _„_ zti,. '�•�__��rr ter+—a-¢�vq�•`'-_ `_ st�s��.._4_� <br /> SERVICE WORK <br /> - Cie a Tech ORDER <br /> Environmental Inc. <br /> 2581 S-Sunland Ave. a Fresno, CA 93725 194813 <br /> Ph-One:800-531-9683 <br /> WASTE RECYCLING RECEIPT <br /> NamB d ! Customer Purchase Order <br /> irc :. Address: J Sales Aepresentative <br /> CIIy, State.dip: — <br /> Phone a; <br /> ' EPA la <br /> Federal Manliest rr: <br /> i QUANTJTY UNITS U.S.DOT DESCRIPTION CKARGE <br /> USED OIL-NON RCRA HAZARDOUS WASTE.LIQUID <br /> . GAL. CA WASTE CODE 221 <br /> GAL- USED ANTI-FREEZE-NON RCRA HAZAROQUS WASTE.LIQUID <br /> ' CA WASTE CODE 134 <br /> OILY WATE{�FROM USED PARTS WASH SOLLMON- <br /> GAL. NON-RCRA HAZARDOUS WASTE,LIQUID. CA WASTE CODE 134 <br /> gill Uj DRUMS St DRAINED USED OIL AND GAS FILTERS <br /> Lu <br /> C7 <br /> m TOTAL. <br /> W The aWw used oil rs Lubricating oil °b Jndustn&I al <br /> F - <br /> J ACCOUNT STATUS- [ }C.O,U. C }OPEN ACCOUNT If open Accouni-payment Is due net 30 days or a finance charge of 1.5% <br /> IL per morsth will apply, <br /> 0 GENERATOR'S M1117f1GATION AND CER7IFICATIOJf:AN tr5ed od Nat the Iransponer rxamts fFpm the garWalor rna be tFargpodw la a termwil used nd r egnman fare Fu that IS <br /> (,� M a e Ab ordaWrrttn w81 a Dpdd waste ratdnrrs permit issued purswnl ro 7ne Federal All �hereby declare Ihet the cgngerlrs pl this ponslQnnrrem are tulry and <br /> tool 0049 pUfia and are classified.pawil;od.marked aid Lbtx 1 and are in as aspbm m Proper[ore 1130n for Ira nspod�y 0.6.T. <br /> • 5ra:4ads Ail releuani informanon hailing known Or SuSPeC'N harards assoc+a1M lnth*5 Waste has befit Or-Mstd the custunwF agrees En pay FeaSor a,0le Cost and art6rne-e <br /> Ices rxvrred n the tohechdn of this o6ow1 On.llanue Ior porposes of rhls oblvatwrr shalt be in Los Ah40s C4dnry I Certify that the+wste minirnwaIrwn statement pdenuf*d in 40 <br /> d CFR 26227taJId l am a large guatbry QMeralor}or 1b)f rf I am a s2ull quantity penerawrl is true I Aw advwvi ledge that I iii read and a0rab to the terms an rhrs corm tFdth front <br /> 0- aAd back Signer gbaranlef5 The payment of CfeanTxh invoices In wnrnarKe with the sondard Iemo bl Nei 30oarS Eta Purchase order is no i557red.in!emorgyee 7urho,ving the <br /> work performed quawiees rhai any Fnviwes presented Wrh EK papa promplrr Prpmpl paymeM 6 defined IS WrmMl m W07(12nce MIT Ckanrecl+Slandard 1eror5 or nel 3+0 days <br /> Yftywe pairimnt rs nN donlrngent upGn paymenr by a third party Interest do past deb acbouetl VM be dwped A Iha rate U1 1 5N per rtlpntn unpr paid In full WASTE MATERI Al.5 <br /> ' WHICH ARE oISCOVERED TO DE NOM-CC NFORMAG WILL 01 SUBJECT TO ADDITIONAL CRARGI?S. <br /> TYPE OR PRINT FULL NAFAEPRINT FULL NAME SrG A E DATE <br /> r I heretK cMufy that I hate read and have the 7ulho-rily to GM the stim listed grew alor to the lerms round on With Iha frprrt a>rd bat#o1 thps form Stall Law ragwrn that WE) <br /> +j] The Gerlarardr and TranspWar keep INS Iortn on file ror 2 mrnrmum of 01 yens r rleffb#Cerlrfy that all Alprmabon rh hips and all alai W documenls Contain true and acrurale <br /> i►• dtwilly *of the Waste including That Ehe Waste 15 segregaled and is r*r iz"iNW wiln 61her waste slfearrid As IN Ctnefwnr 1 ackm*woa Enal our Site EPA iD o is acme Thff <br /> Aaste Stream fisted atole Compries Willi Eric wmre Prahle on record for The desrphaled Fan„ly Thai downenl sines as wriden rerilkellon lhm the reads Mamtrl descrlptlon <br /> and cedrilt"frts Ieund abm are ue[haagad Der the Family Clhltllor We111 Pro1ge Work;sq,and also arts 6S 06 7enual KFillan verlficarlon for the Gentnrer Waste Nuhle <br /> •- r werY dtl of Ihare ward rlrearAS.14eCrare u+eaer penarty of penury Mal the IDrego+ng rs Irue And ro.,na <br /> T. DeanTech Environmental Inc. <br /> ILI <br /> 2581 S. Sunland Ave. A44mee—_ /fi747 <br /> :. a Fresno. CA 93725 DRIVER'S NAME- PE OR PRINT F L NAME <br /> 0- EPA rD It:CALM03681136 <br /> _ Truck, Unit M Na- b b r <br /> h SIGNA U E /ATE <br /> The Checked box is the designated recycling facility <br /> WZ u Aoadrunnef Glycol.Inc. ❑Soulhwest Processors ❑Heritage Environmental 0 CleanteCh Environmental <br /> 41W Induslnal Center Or. 4120 BandEnr Otvd. Services LLC 5820 Martin Rd. <br /> Las Vegas.NV 89115 Yernan,CA 90058 284 East Storey Road Irwindale,CA 91706 <br /> + W EPA r NVRODD38M27 EPA#CAL921646037 Coolidge,AZ 85128 EPA 0 CALOD0330453 <br /> ' Ph 0 702n79-7179 Ph#800/9M-3366 EPA f AZD081705402 Ph E'52H12-7200 <br /> CL ix N 0 52C1723-4167 <br />