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BRANCH 718501 CSG K FLOWS,PAIRICK 08/11104 14:08 PAGE I <br /> Safety -Kleen <br /> 5400 Legacy Dr. <br /> Caster It. Building 3 <br /> Plano, Texas 75024 <br /> 209-545-1011 <br /> REFERENCE MR <br /> CUSTOMER# 2225819 END OF THE LINE AUTO RPR 0026800659 <br /> SERVICE TAM 0.07750 200 COMMERCE #101 SRVC AEEN: o4-32 <br /> CONS TAM: 0 00000 SRVC DATE: 08111!94 14:06 <br /> PROOLICI TAM: 0.07750 LODI - CA 95240 <br /> PHOW 209-365-6077 <br /> PURCHASE OROE8# TAM EXEMPTION NOR: <br /> PRODUCT/SERVICES <br /> SERVICE) TOTAL <br /> SERI=T OTY LIMIT PRICE TAM CHARGE <br /> 100009 FUEL- FEE SURCHARGE 1 8.1500 0.00 8.15 <br /> 90830 40EL 90 W12370 6 6317 1 209.5500 16.24 225.79 <br /> 21025 CLEAN 5 SPENT 0 <br /> SERVICE TERM 12 <br /> 92383 2383 PUMP ASSEMBLY 1 0.0000 0.00 0.00 <br /> 1 CLEAN 0 SPENT 0 <br /> SERVICE TERM 12 <br /> CAUSE CODE C INV CODE T <br /> ------------- <br /> TOTAL SERVICE/PAOOUCTS 217.7000 16.24 233.94 <br /> USEPA TRANSPORTER 1 TMR000050930 GENERATOR USEPAvCAL000241686 <br /> USEPA TRANSPORTER 2 GENERATOR STATE <br /> MANIFEST DOC #23695184 FORM COOS 10 <br /> US DDT DESCRIPTION (INCLUDING PROPER SUPPING NAME, HAZARD CLASS. AND ID <br /> USED CLEANING 00 POIWOS, N.G.I.B.N. <br /> LIQUID (NOT USEOT OR USEPA REGULATED) <br /> AQUEOUS PARTS WASHER SOLUTION (8.3") <br /> TOTAL CONT 1 TWE ON TTL OTY 17 UNIT WTIVOL G SHOOT 941 <br /> CONTAINER#40529081613 OTY 17 WASTE CODE CA 134 <br /> DESIGNATED FACILITY NAkEIAOORESS: <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 5050 SALIDA BLVD <br /> SALIDA CA 95368 <br /> USEPA ID NET CAT000613968 TOTAL CHARGE 233.94 <br /> STATE iO NO CAT00061W% WASTE MIN 0,00 <br /> TOTAL DUE ••-----233.94 <br /> OFAIO BALANCE THIS RECEIPT 233.94 <br /> Machine clean and good cordition? Yes <br /> Deals inplace and legible? Yes <br /> Fusible link Installed! Yes <br /> Emergency closing of Ild unobstructed? Yes <br /> Machine properly grounded? Yes <br /> Spent solvent meets acceptance criteria? Yes <br /> Prop 65 warning (Calf. only)? Yes <br /> GENERATOR STATUS 0 - 220 Ibstmonth <br /> The generator has established a program to reduce the volume or <br /> quantity and toxicity of the hazardous waste to the degree, as deteramed <br /> by the generator, to be economical ly practicable. <br /> Customer certifies that (i) the above-carted 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 /> Dopar insert of Transpor Jai ion and (Ii) n, meter ial change has occurred <br /> either in the characteristics of the waste materials or In the process <br /> generating the waste materials. Customer agrees to pay the above <br /> charges and to be bound by the forms and conditions (1) set forth in fa) <br /> the General Terms and Conditions provided separately to Customer or <br /> (6) any SK a regiment signed by Cusloaer and , and (2) Incorporated <br /> herein by reference. Unless otherwise Indicated in the payment <br /> received section, SK is authorized to charge Cusloser's account for this <br /> transaction. Custamer certifies that the Individual signing this Service <br /> Acknowledgement is duly authorized to sign and bind Customer. <br /> IN THE EVENT OF AN ETER(EWY CALL 1-800.468.1760 (24 hours) <br /> SIGNATURE NNE: MATT WAGNER <br />