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BRANCH SSL CSG 60 Joseph Lima Jr 07/23/14 14:51 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 400 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMER# C082732 Con J Franke Electric Inc 63926601 <br /> 317 N Grant St SRVC WEEK: 2014-27 <br /> Stockton CA 95202-2633 SRVC DATE: 07/23/14 14:49 <br /> PHONE 209-462-0717 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> C002732 Con J Franke Electric Inc <br /> 317 N Grant St <br /> Stockton CA 95202-2633 <br /> PHONE 209-462-0717 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 781816/ <br /> 875000 LOD FOR FUEL 55GL 1.000 0.0000 0.00 0.00 <br /> SERVICE TERM 12 WEEK <br /> CAUSE CODE VoidReaderAndLine -SERVICE NOT NEEDED <br /> 66641 USED OIL PER STOP (NON PR 110.000 75.0000 0.00 75.00 <br /> SERVICE TERN 24 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPM < 1000 <br /> 100001 FEE, FUEL SURCHARGE 1.000 16.4500 0.00 16.45 <br /> TOTAL SERVICE/PRODUCTS 91.4500 0.00 91.45 <br /> CREDITS 0.00 <br /> TOTAL DUE 91.45 <br /> UNPAID BALANCE THIS RECEIPT 91.45 <br /> RECEIVED <br /> If high risk source, SK rep. certifies that load specific PCB 4 r,-,p G 9 2016 <br /> Silicon testing have been completed prior to pumping this load. <br /> ENVIRONMENTAL HEALTH <br /> GENERATOR STATUS PERMIT/SERVICES <br /> CESQG: Vehicle <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 /> signing this Service Acknowledgement is duly authorized to sign and <br /> bind Customer. The following provision is applicable to Safety-Kleen's <br /> parts cleaner and paint gun cleaner services: Customer agrees that it <br /> will not introduce any substance into the solvent or aqueous cleaning <br /> solution, including without limitation any hazardous waste or <br /> hazardous waste constituent, except to the extent such introduction is <br /> incidental to the normal use of the machine. Customer further agrees <br /> that it will not clean parts/paint guns that have been contaminated <br /> C <br />