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C <br /> !6 Di <br /> 3 W <br /> 4Tf <br /> /1718501 CSG 2S ESCAMILLA,DAvIO 03/04/09 16:04 PAGE <br /> i° <br /> Safety-M een a <br /> 5400 Legacy Or, b <br /> Cluster II, Building 3 C <br /> Plano, Texas 75024 d <br /> ZD9-545-1011 41 <br /> REFERENCE N8� <br /> CUSTOMER# 3264660 TRACY CHRYSLER JEEP DODGE 0038478688 <br /> SERVICE TAX: 0.O77SO 3460 NAGLEE RD SRVC WEEK: 09-10 <br /> COMS TAX: 0.00000 SRVC DATE: 03/04/09 15:400 <br /> PRODUCT TAX: 0.07750 TRACY CA 95304 co <br /> � <br /> PHONE 209-820-1800 <br /> PURCHASE ORDER# 71060 TAX EXEMPTION NBR: y <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL 3 <br /> PRODUCT QTY UNIT PRICE TAX CHARG� <br /> 2387 HEATER-PUMP-MODULE ASSEMBLY 0 0.0000 0.00 O.0P� <br /> 92387 2387 PUMP ASSEMBLY 1 0.0000 0.00 0.00 <br /> S/N &021508 TAG 00002387Sk08021S08 CLEAN 0 SPENT 0 e <br /> SERVICE TERM 8 'Oa' <br /> es <br /> 92387 2387 PUMP ASSEMBLY 1 0.0000 0.00 0.00 <br /> S/N 8013161 TAG 00002387SK0801316L CLEAN 0 SPENT 0 <br /> SERVICE TERM 8 <br /> 90837 MODEL 90 W/?387 & 6317 1. 191.5900 14.85 206.4C _ <br /> S/N 50879 TAG T000000OXX9020965/ CLEAN 5 SPENT 0 <br /> SERVICE TERM 8 <br /> 90837 MODEL 90 W/2387 & 6317 1 191.5900 14.85 206.4 <br /> S/N 11288 TAG TOOOOOOOXX90209658 CLEAN 5 SPENT 0 <br /> SERVICE TERM 8 <br /> 100009 FUEL FEE SURCHARGE 1 9.S400 0.74 10.28rm <br /> ----------------------------------------D <br /> TOTAL SERVICE/PRODUCTS 392,7200 30.44 423.16 N <br /> USEPA TRANSPORTER 1 1XR000050930 GENERATOR USEPA CAL000332356 <br /> USEPA TRANSPORTER 2 GENERATOR STATE � <br /> MANIFEST DOC # 001747837SKS FORM CODE 10 <br /> US DOT DESCRIPTION (INCLUDIN(; PROPER SHIPPING NAME, HAZARD CLASS, AND 10) <br /> NON-RCRA HAZARDOUS WASTE, LIQUID 44 <br /> ({AQUEOUS PARTS WASHER SOLUTION) 0 <br /> TOTAL CONT 2 TYPE OM lit QTY 50 UNITWC/VOL G SKOOT 14941 . <br /> CNT# 90207057806 QTY 25 WASTE CODE CA 134 40N <br /> CNT# 9OZO7057307 QTY 25 WASTE CODE CA 134 0 <br /> DESIGNATED FACILITY NAME/ADDRESS: <br /> SAFETY-KLEEN SYSTEMS, INC, <br /> 6000 88TH STREET <br /> SACRAMENTO CA 95828 <br /> USEPA ID NO CA0000094517 10TAL CHARGE 423.16 <br /> STATE ID NO WASTE MIN 0.00 m <br /> -------------ZL= <br /> TOTAL DUE <br /> UNPAID BALANCE THIS RECEIPT 423.16 <br /> Machine clean and good condition? Yes \ <br /> Decals in place and legible? Yes \ <br /> Fusible link installed? Yes <br /> Emergency closing of lid unobstructed? Yes E <br /> Machine properly grounded? Yes 0 <br /> Spent solvent meets acceptance criteria? Yes Ll <br /> Prop 65 warning (Calif. only)? Yes 4 <br /> C <br /> GENERATOR STATUS 81 <br /> 220 - 2200 lbs/month <br /> ,iii <br />