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BRANCH SSL CSG 24 David Buxton 10/16/14 17:15 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> �. 2600 N Central Expy, Suite 400 <br /> Richardson, TX 75080 <br /> CORPORATE: 600-669-574D <br /> Z4 HR EMERGENCY: 800-468-1760 (Safety-Klean) <br /> 2095451011 <br /> REFERENCE NSR. <br /> CUSTOMER# GE26023 Lodi Toyota Scion 64924292 <br /> 1020 S Beckman Rd SRVC WEEKS 2014-42 <br /> Lodi CA 95240.3152 SRVC DATES 10/16/14 17:15 <br /> PHONE 5S9-408-8040 <br /> BILL TO CUSTOMER# 09LL TO ADDRESS: <br /> GEZ6023 Lodi Toyota Scion <br /> 1020 S Backman Rd <br /> Lodi CA 95240-3152 <br /> PRONE 559-015-8040 <br /> PURCHASE OHULHf S809 TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRUOULI QTY UNIT PRICE TAX CHARGE <br /> $3383 DRUM,55 WASIt O.F. 5.000 0.0000 0.00 0.00 <br /> SERVICE TERM 8 WEEK <br /> 3383 DRUM,SS GAL FOR O.F. 5.000 0,0000 0100 0100 <br /> SERVICE TERM B WEEK <br /> 3207 BOX FLOR BULBS 8' 2.ODO $9.0000 0.00 118.00 <br /> SERVICE TERM Z4 WEEK <br /> 3324 DRUM, 16 GL BLACK STEEL 0 1.000 47.0000 3.76 $0.76 <br /> 83207 WASTE 8' FLORSULB CST 11000 0.0000 0.00 0.00 <br /> SERVICE TERM 24 WEEK <br /> 8 CONIS: I 15ufi 11 MANIFESI8: 5S805 10101 CUS BL SK SHIPS 21444!274 <br /> CN101 1410155361/3 QTY: SO Wf/VOL P PROF# 156056 SKDOT 14815 <br /> IODO01 FEE, FUEL SURCHARGE 1.000 15.7900 1.26 17.05 <br /> 3230 TAX HANULING N/C DRUM DROP 3U 7.003 0.0000 0.00 0.00 <br /> ----------------------------------------- <br /> TOTAL SEKVICE/PROOUCTS 121.7900 5.02 185.81 <br /> TOTAL CHARGE 185.81 <br /> CREDITS 0.00 <br /> TOTAL OUE <br /> araccaccacccca� <br /> UNPAID BALANCE THIS RECEIPT 165.61 <br /> GENERATOR STATUS �s <br /> 0-220 lbs/month <br /> Custwi;er certifies that (i) the above-named materials are properly <br /> o a- ified, packa0ed, marked sad labeled, and are hr Proper tvndilion <br /> fur lranspurtefiorr au urdiug to the npplirablr reyul.timrs of fila <br /> DeParfi.wot ••f T^r+:rvr•l nl ivn vnl liil nv:.alr<r ial .b.....P hAS .......,.....t <br /> RECEIVED <br /> i V 0 3 2014 <br />