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BRANCH 7192 CSG 24 David Buxton 08/12/13 19:19 PAGE 1 mECEIVER-) <br />Safety-Kleen Systems, Inc. AUG 0 7 2015 <br />2600 N Central Expy, Suite 400 <br />Richardson, TX 75080 <br />800-669-5790NVIRONMENTA. <br />209-595-1011 ;�ta''Tii"ic"�4pi'�!�P.IT <br />REFERENCE NBR. <br />CUSTOMER# 10007042 MCNEILUS TRUCK 61569597 <br />3100 N Ad Art Rd SRVC WEEK: 2013-33 <br />ATTN: RALPH CCRTEZ SRVC DATE: 08/12/13 14:18 <br />Stockton CA 95215-2218 <br />PHONE 209-931-4282 <br />BILL TO CUSTOMER# BILL TO ADDRESS: <br />10007042 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# TAX EXEMPTION HER <br />PRODUCT/SERVICES <br />SERVICE/ TOTAL <br />PRODUCT QTY UNIT PRICE TAX CHARGE <br />90701083/ <br />876530 CAL UNIVERSAL AEROSOLS 55 1.D00 <br />SERVICE TERM 24 WEEK <br /># CONTS: 1 TSDF: 7221 MANIFEST#: 69597 <br />CNT#: 130812696309 QTY: 125 WT/VOL P <br />3369 DRUM, 55 GL BLACK STEEL 0 1.000 <br />SERVICE TERM 24 WEEK <br />385.0000 0.00 385.00 <br />FORM CD: BL SK SHIP# 210956724 <br />PROFILE: 040701083SKDCT 7369417 <br />87.0000 6.96 93.96 <br />7646 ABSORBENT, OIL AND LIQUID 4.000 5.5000 1.76 23.76 <br />SERVICE TERM 24 WEEK <br />100001 FEE, FUEL SURCHARGE 1.000 16.1200 1.29 17.41 <br />----------------------------------------- <br />TOTAL SERVICE/PRODUCTS 493.6200 10.01 520.13 <br />TOTAL CHARGE 520.13 <br />CREDITS 0.00 <br />--------------- <br />TOTAL DUE 520.13 <br />UNPAID BALANCE THIS RECEIPT 520.13 <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 />Page 25 <br />