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BRANCH SSL CSG 24 David Buxton 12/03/13 09:47 PAGERCEI VE D <br />UNPAID BALANCE THIS RECEIPT 441.37 <br />GENERATOR STATUS <br />0-220 lbs/month <br />Customer certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />for transportation according to the applicable regulations of the <br />Department of Transportation and (ii) no material change has occurred <br />either in the characteristics of the waste/material or in the process <br />generating the waste/material. Customer agrees to pay the above <br />charges and to be bound by the terms and conditions (1) set forth in <br />(a) the General Terms and Conditions provided separately to Customer <br />or (b) any SK agreement signed by Customer and SK, and (2) <br />incorporated herein by reference. Unless otherwise indicated in the <br />payment received section, SK is authorized to charge Customer's <br />account for this transaction. Customer certifies that the individual <br />Page 7 <br />AUG 0 7 2015 <br />Safety-Kleen Systems, Inc. <br />2600 N Central Expy, Suite 400 <br />Richardson, TX 75080 <br />,i Y1� <br />ENVI 4N MENTAL <br />800-669-5740 <br />14"1-fj rlco?�oTgAr�kT <br />2095451011 <br />REFERENCE NSR. <br />CUSTOMER# <br />MC22499 Mcneilus Truck <br />62415931 <br />3100 N Ad Art Rd SRVC WEEK: 2013-48 <br />Attn: Ralph Cortez SRVC DATE: <br />12/03/13 09:46 <br />Stockton CA 95215-2218 <br />PHONE 209-931-4282 <br />BILL TO CUSTOMER# <br />BILL TO ADDRESS: <br />MC22499 <br />Mcneilus Truck <br />3100 N Ad Art Rd <br />Attn: Ralph Cortez <br />Stockton CA 95215-2218 <br />PHONE 209-931-4282 <br />PURCHASE ORDER# <br />TAX <br />EXEMPTION NBR <br />PRODUCTISERVICES <br />SERVICE/ <br />TOTAL <br />PRODUCT <br />QTY UNIT PRICE <br />TAX CHARGE <br />40604463/ <br />875060 <br />ORGNC SLD FOR FUEL 55GL 1.000 330.0000 <br />0.00 330.00 <br />SERVICE TERM 24 WEEK <br /># CONTS: 1 <br />TSDF: AG MANIFEST#: 003963913SYS FORM CD: US SK <br />SHIP# 211786553 <br />CNT#: <br />131127235033 QTY: 300 WT/VOL P PROFILE: 040604463SKDOT <br />7369381 <br />3369 <br />DRUM, 55 GL BLACK STEEL 0 1.000 87.0000 <br />6.96 93.96 <br />SERVICE TERM 24 WEEK <br />100001 <br />FEE, FUEL SURCHARGE 1.000 16.1200 <br />1.29 17.41 <br />----------------------------------------- <br />TOTAL SERVICE/PRODUCTS 433.1200 <br />8.25 441.37 <br />TOTAL CHARGE <br />441.37 <br />CREDITS <br />0.00 <br />TOTAL DUE <br />--------------- <br />441.37 <br />UNPAID BALANCE THIS RECEIPT 441.37 <br />GENERATOR STATUS <br />0-220 lbs/month <br />Customer certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />for transportation according to the applicable regulations of the <br />Department of Transportation and (ii) no material change has occurred <br />either in the characteristics of the waste/material or in the process <br />generating the waste/material. Customer agrees to pay the above <br />charges and to be bound by the terms and conditions (1) set forth in <br />(a) the General Terms and Conditions provided separately to Customer <br />or (b) any SK agreement signed by Customer and SK, and (2) <br />incorporated herein by reference. Unless otherwise indicated in the <br />payment received section, SK is authorized to charge Customer's <br />account for this transaction. Customer certifies that the individual <br />Page 7 <br />