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<br /> YfilliNCH 7142 CSL 2S UESCAMI, 05/03/10 15:34 PAGE 1
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<br /> Safety-Kleen Systems, Inc. E
<br /> UIIANCH 7142 CSI, 25 DESCJNII, 05/03/10 IS:35 PAGE.x $360 Legacy Drive. y
<br /> 44 Building 2, Suite 100
<br /> REFERENCE NVR.
<br /> Plano, Taxes 75024
<br /> � 6,
<br /> LUSIUI1LIIM/4tNLHAWH: JO/0576 YANUtLL IISUtNINI;
<br /> $p83334Y R3 600-669-5710
<br /> 6540 W Linne lid N 209-SIS-3011 •�A
<br /> Tracy CA 95304-DIOU SRVC DATE: 05/03/304 REFERENCE NOR. J9
<br /> PHONE 209-405-0107 TOMEkS 3070576 YANDELL TRUCKING 50637340 f
<br /> 4tNEHA7UH UStPa 41). tRIUU0198194 Gt(VERAIOH STATE 6660 W Linne Rd, SRVC WEEK: 2010-19 34
<br /> MAN1tLS1 DOC#: UUZSUr266SK5 "HM CODE: US SK SHIPMENI-NO: 2QU8Z40$b = Tracy CA 95301-9109 SRVC DATE: OS/03/10 15:31 a
<br /> CARRIER 1 Tx4t0000S0930 `` PHONE 209-465-0107 re.
<br /> CARRIER 2 PORiHASE ORDERS TAX EXEMPTION NOR y
<br /> PRODUCT/SERVICES
<br /> US UU1 UtSLHLPILUN (�LNLLUUING PROPLH SHIPPING NAME, HAZARD CLASS, AND LU)
<br /> IORVICE/ TOTAL
<br /> HQ WAbrt PAiNI kti-AtED MATERIALS 3 OUCT QTY UNIT PRICE TAX CHARGE
<br /> UN1267 PG II (0001) /
<br /> (ERGS128)
<br /> rt0tNAL WASI1: COOLS rune tuns Uuo1 UU3S Uuus 0Uo6 000/ UOOS 0 FUEL bLENU LIQ >12000 SSG l.b0o 255.ODo0 D.oO 255.00
<br /> S1ATE WASTE CODES 213 SERVICE TERM 6
<br /> 101AL CONI 1 'TYPE DN WT/VOL P SkOOT 400053
<br /> PROMO NBR: 0 a
<br /> (NIS: 10042806544S QTY: 450 PROFILE: 0121/5 CA CAT CODE: 3�
<br /> I388YY EMPTY DRUM 55 1.000 66.1000 7,56 93.96
<br /> OtSI41NIATEU tACILIlY NAME/AUDHESS: E SZWCC TLRM a
<br /> SAFETY-KLEEN SYS II MS, INC. PROMO NOR: 0
<br /> 1722 COOPER CREEK HOAU 10$01 FEE, tUEL SURCHARGE 1.000 12.2600 1.07DENT13.33 bq
<br /> 1722 C TX 76296
<br /> TOTAL SERVICE/PROOUCTS 353.6600 5..63 362.29
<br /> tACILIIY USEPA 11) NO TXD077603371 6)
<br /> ;aCILITY STaIE IU NO 65124 TOTAL CHARGE 362.29
<br /> t ,
<br /> CREDITS 0-DO-- E
<br /> TOTAL DUE 362,29 Y
<br /> GENLRAIUR STATUS
<br /> 0 - Z20 lbs/rlranth ,B
<br /> 10 UNPAID BALANCE THIS RECEIPT 362.29
<br /> Customer certifies that 0) tine abuva-natued materials era pruperly E.
<br /> classified, packaged, Marked rid labeled, and are in pruper cundltion ..r
<br /> tar tl•LUnspurtoti ml according to tilt applicable reyulatiuns of the 'dt
<br /> Dopar tnleul of Transpurlatiun and 01) s.0 material change has occurred �, 9s
<br /> .ither ii the characteristics of the webta/olateriol ur in the Process
<br /> Uenerat UlU the was Le/milter'ial. Cast 011ler agrees to Pay the above GEAtRATOq STATUS 41•.
<br /> .homes and to he bound by the terms and conditions (1) set forth in g ta2A0 lbs/month
<br /> (a) the General Tends and Conditions provided separrtely to Custolner i N
<br /> r (b) duly SK aoreenlent signed by Custoiner at SK, and (2)
<br /> mcarporated herein by reference. Unless utberwiss indicated in the C omen certifies that (1) the above-nartled niater'ials are properly
<br /> paynernt receival section, SK is uulhorized to charge CustwnerIs cl ified, packaged, marked and labeled, and are in Proper condition '3
<br /> ALeurnt for this transactiun. CusUnutr certifies that the individual f transportation according to the applicable reyalatlalls or the
<br /> signing this.ServlLe ALknowleduelnelit is duly authorized to sign slid Oa rtnlent of Transportation and (i i) no material change has occurred \
<br /> bind Customer'. Thr following Provision is apIlliLablp to 5afaty-Kleen's e r in the characteristics of the waste/material or in the process
<br /> vtill the waste l
<br /> parts tlraner dull Paint gun C1aYller services: Customer• agrees that it 9 Y /lutariel. Custunler agrees to pay the above e
<br /> will not introduLa any substanLo into the solvent or aqueous cleaning chaFges and to be bound by the terms and conditions (1) set forth in w
<br /> sulutian, including without limitation mill, hazardous waste or (aiahe General Tarnts and Conditions provided separately to Customer r
<br /> haaordaos wasto urnstituart, except to the extent such introduction is or (M any SK agreement signed by Customer and SK, and (Z) 4
<br /> InLidmltal to the normal use of the nwchiie. Custwner further agrees in pasted heroin by reference. Upless otherwise indicated in the
<br /> tt..t it will not le..0 parts/paint guns that have been conta:uinated III# nt received section. SK is authorized to charge Custower's
<br /> Reith or utherylise intr'odace polychlorinated biphenyls WWI), accwnt for this transaction. Custolllar certifies that tier individual
<br /> herbicides, pestiLides, dioxins or listed hazardous waste into the sig ng this Servics Acknowledgement is duly authorized to sign and
<br /> solvent up it cleaHiny solution. Safety-kleen has the capacity Lin customer. Tha following provision Is applicable to Safety-Kleerr's
<br /> and is pavnitted to recryt, store and/ur reclriw the spout pats Par cleaner and paint gun cleaner services: Custahler agrees that it \
<br /> „ashes' solvent; paint thinners, solvents will paints generated by dui not introduce an substance into the solvent or aqueous cloaniig
<br /> powder, and still so ion, including without lialitation any hazardous waste or
<br /> eustauar; up Apt daaniay filter cartridges, 1 haz rduus waste constituart, except to the extent such introduction is E
<br /> residues containing perchlur•oath ylane, petroleum naphtha, or P p
<br /> U iflurutrichluruelhane Ary cleaning solvents. Safety Kneen and in ectal to the normal use of the machine. Customer further agrees y
<br /> L11)taillC l' uU,'ttl that this agra■ulent is intendad to satisfy the thrV it will not clean parts/paint guns that have been coutalninatad a
<br /> requirelllents of 40 CFR 26Z.20(e). IN THE EVENT Of AN EMERGENCY CALL wi64 or otherwise introduce pelychlorinatad biphenyls aKO's), C
<br /> her tides, pesticides, dioxins or listed hazardous waste into the 6)
<br /> 1.600-aG8-1760 (2s. hour's) sol nt or aquejus Lleaning solution. Safaty-kleen has the capacity
<br /> nd
<br /> as per+nitte to accept• store, and/or reclaim the spent parts �L
<br /> was r solvent; point thinners, solvents and paints Venerated by r
<br /> sus mer; or dr cleaning filter cartridges, powder, and still
<br /> res uac containing perchloroothylone, petroleum naphtha, or
<br /> tr rutrichlo uethana dry cleaning solvents. Safety-kleen mid t�
<br /> sus lar agree that this agreement s intended to satisfy the A
<br /> �i a-- re W renients of 40 CFR 262.20(.). IN THE EVENT Of AN EMERGENCY CALL y
<br /> r 1-�-466-1760 (24 hours)
<br /> CUSTOMER / GENERATOR :enrigue E
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