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06/01/2011 22: 52 2091655220 ABC FOOD MART PAGE 02106 <br /> - I s <br /> BR*KH Tec .36 24 dbuxton, 05/25/11 1. PAGE 1` <br /> Safety-Kleen Systems, Inc. <br /> 5360 Legacy Drive. <br /> Building 2, Suite 100 <br /> Plano, Texas 75024 M, <br /> 800-660-5740 V, <br /> 209-545-1011 <br /> REFERENCENo-` <br /> 06 <br /> CUSTWER0 109766 VALERO LA! SlAT20N 54183955 <br /> 713 N El Dorado St SRVC WEEK: 201I-22 E <br /> AM: VIC ]UOGE SRVC LATE: 05/25/11 X1,290 <br /> Stockton CA 95201-1601 .V <br /> PHONE 204-46S-5221 C' <br /> PURCHASE ORDERS TAX EXEMPTION NOR � <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL .W <br /> FROOMT QT( UNIT PRICE TAX CHARGE <br /> 404957701 df <br /> 87 LANDF NON USDOT HALMAI, N 1.000 150.0000 0.00 150.00 w <br /> SOMICE TERM 0 WEEK A <br /> PROMO NRR: 0 N 7N rs NIS: 1 75Df: MAn1Ft5ls: 002tlN244SCO <br /> kS rORM : US SK SH1Yi 209135104 <br /> 3 <br /> CNIN: 110524919454 QTY: 41S wt/VOL V V"O I t: 0404a57/OSKUOI AWS645 <br /> 3369 DRUM, 55 GL SLACK S1EEL 0 0.000 0.0000 0.00 0.00 <br /> SERVICE TERM 24 WEEK <br /> 3369 DRUM, SS G{, BLACK STEEL 0 0.000 0.0000 0.00 0.00 <br /> SFAWCE TFM 24 WRKK <br /> e <br /> 10TAL SEMCE/Pk00UC15 150.0000 0.00 150.00 e <br /> 0 <br /> TOTAL CHARGE -'150.00 <br /> CRED1lS 0.00 <br /> TOTAL DUE ---- iso 00 rlaw <br /> UNPAX0 BALANCE THIS RECEIPT 150.00 <br /> E <br /> O <br /> V <br /> R <br /> G TDR STATUS UO <br /> 22 1bs/m.nth r <br /> x <br /> in ended to satisfy the requirements of 40 CFR 262.WA). IN THE EVENT I <br /> OF EMERGENCY CALL 24 MR EMERGENCY 4 1-100-4n1-1760 (Safety-Klee. <br /> C tract ! 94131) Customer certifi.s that (1) the above-pl0ntd r <br /> rm eriala are properly cldssified, packaged, marked and labeled, and m <br /> w <br /> ar in proper cundiLiun for trsnaporLatioa a«ordinq to the apylieablc 40 <br /> rt lotions of the Department of Trarrsportalion and (ii) no material ~ <br /> chhas occurred either i. the charactirixtics of tht r <br /> wast!/thaterial or in the process gemeraHug the waste/material. <br /> C toner ogre. to pay the above charges and to be bound by the terns <br /> conditions (1) set forth in (s) the General Terms and Conditions <br /> P'±4 <br /> ieyarattly to CustwUer or 0)) any SK aVeeeinent signed by <br /> Co taCa:r amt SK, and (2) incorporated her.in by r%ferortc•, Unlaai <br /> of erwise ihdiuttd in, the panuept received section. SK is authorized Y <br /> to charge Customer's account for this transaction. Custamcr certifies <br /> that the individual signing Lhis Service Acknowledgement is duly <br /> w Iwrized to sign and bind Custonmr, the following pruvialon is <br /> applicable to Safety-Kleon's parts cleaner and paint gun cleaner <br /> services; Custauer agrees that it will nut introduce any suhstante <br /> into the solvent or aqueous cleaning solution, including without !�y <br /> lh itation any hazardous wase or haxardous watiLa conitituent, except Y@ <br /> to the extent such introduction i> incidcatal Lo the normal use of the - <br /> u int. Custmuer further agrees that it will not clean parts/paint <br /> q that have belt e6ntauinated with or otherwise introduce ._ <br /> polychlorinated biphenyls (PCs'*), herbicides, pesticides, dioxins or <br /> lis�Sed hazardous waste into the solvent or aqueous cleaning solution_ <br /> Safety-Kleen has the capacity and is penritted to accept, store, Y <br /> a.�/or reclaiin the ap.nt parts washer solvent; paint thinners, it <br /> solvents and paints generated by cw lane r; or dry cleaning Filter <br /> cartridges, powder, end still residut� tants in inn perchloroethylano, <br /> pet!roleuai napbtba, or tri Flurotrichlorne than. Iry cleaning soluchti. ,y <br /> Saflety-Klein and custonror agree that this agre�meent is <br /> ry <br /> m <br /> sw <br /> !0 <br /> a <br /> X 3 <br /> CUSTOMER / GENERATOR wic sing <br /> • <br /> LAST PAGE <br /> as <br /> �A <br /> 1 <br /> C <br />