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BRANCH SSL CSG 24 David Buxton 04/20/15 13:32 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 209S451011 <br /> REFERENCE NBR. <br /> CUSTOMER# HE25320 Heartland Steel 66313357 <br /> 213 Kelly St SRVC WEEK: 2015-14 <br /> Lodi CA 95240-3107 SRVC DATE: 04/20/15 13:32 <br /> PHONE 951-784-2133 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> NE25320 Heartland Steel <br /> 213 Kelly St <br /> Lodi CA 95240-3107 <br /> PHONE 951-784-2133 <br /> PURCHASE ORDERS TAX EXEMPTS <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 753978/ <br /> 875465 NON HAZARDOUS SOLID CYB 1.000 287.2000 0.00 287.20 <br /> RECEIVED SERVICE TERM 8 WEEK <br /> # CONIS: 1 ISOF': S3 MANIFEST#: 004/6S444SKS FUHM CU: US SK SHIPS Z1S848863 <br /> CN1#; ISO409241078 QTY: 1080 W'I/Vt/l. P PROFS 150;78 SKtHII 7940918 <br /> 770SSS/ <br /> MAY 2 7 2 015 875920 NON-HAZ WASTE FOR INC' 55 1.000 0.0000 0.00 0.00 <br /> SERVICE TERM 8 WEEK <br /> CAUSE CODE VoidHeaderAndl_ine -SERVICE NOT NEEDED <br /> ENVIRONMENTAL, 8W 3369 DRUM, 55 GL B1.ACX SFEFL D 9.000 57.51 41.41 559.0 <br /> SERVICE TERM 24 WEEK <br /> HFAtTH DFRARTMENT CSM REMARKS N/A <br /> 753%1/ <br /> 875480 NON HAZ SEMI-SLDS 5561. 5.000 224.2300 0.00 1121.15 <br /> SERVICE TERM 12 WEEK <br /> F LON ii: 1SU7: BL M.A,Y1i LS 19: 00474i37Ciw:> t0iti•i LO: tC SK SHIP. 21S44.786S <br /> CN T*: 150409241094 QTY: 448 WT/VOL P PROF# 753961 SKOOI !440972 <br /> CNI#: 150409241095 QTY: 481 WT/VOL P PROF# 751961 SXU01 7440972 <br /> CIV I#: 1SO4OW41096 QTY: 436 W1,/VOL P PROF# ?53961 SKDOI 1440VZ <br /> CMT#: 15040924309: QIY: 554 WT/VOL P PROFS 753961 SKVOI :440912 <br /> CN'1#: 150509241098 QTY: J01 Wl,"L P PROF# 753961 SKUO1 7440972 <br /> 753935/ <br /> 871060 CHAR SOL/SEMI S'IABLZ SSE. 4.000 344.9200 0.00 1379.68 <br /> SERVICE TERM 12 WEEK <br /> 9 CGHT�' 4 TSDF, S11 PANIFCST#: 0047,i444 9- FURM CL:: OS i. SHIP;+ 71S9-;96f,' <br /> CN'19: 150409241065 QTY: 794 W.1/VUL P PROF# 753915 SKUUT 7440.115 <br /> CNI#: 150409241066 QIY: 797 WT/VOL P PROF# 753935 SKVOT /440915 <br /> CNT#: 150409243061 QIY: 800 WI/VOL P PROF? /53935 SXUUT 7440915 <br /> CN1#: 150409241068 QIY: 799 WI/VOL P PROFC 751935 SKU01 7440915 <br /> 363; BOX, 1 YARD 5 WALL CORRUG 2.000 160.3600 25.66 346.38 <br /> SERVICE TERM 24 WEEK <br /> 3383 DRUM,55 GAL FOR O.F. 1.000 10.0000 0.00 10.00 <br /> SERVICE TERM 24 WEEK <br /> 83383 DRt1M,5S WASTE O.F. 1.000 80.0000 0.00 80.00 <br /> SERVICE TERM 24 WEEK <br /> 100001 FEE, FUEL SURCHARGE 1.000 12.1500 0.97 13.12 <br /> 3230 TAX HANDLING N/C DRUM! DROP 30 1.000 0.0000 0.00 0.00 <br /> ---------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 1176.3700 68.04 3796.53 <br /> TOTAL CHARGE 37%.53 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 3796.53 <br /> UNPAID BALANCE THIS RECEIPT 3796.53 <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Cost"".." certifies that (i) the above-Hawed .-t-Aals ar'e properly <br /> c1a»:tied, packaged, marked and labeled, and are in proper canditiuu <br /> -'-fn. irac!_y!orlatlon eer-rding to the applicable regolotiorrs of the <br /> n...�.-t..._.., ..r Trnnsyortat ion . !d (ii) mq e[e•.i+..l _I!>nLe has occorr-1 <br /> e:rb <br /> 0- the w.asle/matorial or iu the process <br /> • +!:•... t1.+ c!15toi e, agrees to pay the above <br /> be bound by the terms and conditions (1) set forth in <br /> _. .'..l Terns ­4 fon-{;tions provided separately to cttstam,er <br /> ..greement signed by Customer and SK, and (2) <br /> by rrfer•rnc r. Ibrlrss nlher•w isr ind ir.alyd in the <br /> .. .�.t seclimy SK is authorized to charge Cact,rner's <br /> .. transection Customer certifi+s that the individual <br /> ce Ar.k nowle,l�ement i. dolt' authorized to siyrn and <br /> bi-•' The following provision is applicable to Safety-Kleen's <br /> earl- •_-••-• -^•1 paint gem rlemrer services C-I..--er ngrers that it. <br /> will !e 1 ;0--­!--(e arty ,Ab tarree into tice �olv­at or agtreoes cleanir:g <br /> solution. including without limitation any hazardous waste or <br /> Irazerdo!rs we.te ".-I itoent; ept to the +tent swh int".4 tion i, <br /> incidental to the'nveynal use of the machine. Custmirer further agrees <br /> that it will not clean parts/paint guns that have been cvnlarninated <br /> with or otherwise introduce polychlorinated biphenyls (PCB's), <br />