Laserfiche WebLink
BRNO 718501 CS6 25 FLOES,PATRICK ilAbIM <br /> Safety-Kleen <br /> 5400 Legacy Or. <br /> Cluster 11, Building 3 <br /> Plano, Tens 75024 <br /> 209-545-1011 <br /> REFERENCE NOR <br /> CUSTUER# 7125819 END OF THE LINE AUTO BPR 0027455913 <br /> SERVICE TAX: 0.07750 200 COMMERCE 8101 SRVC WEEK: 04-44 <br /> CONS TAX: 0.00000 SRVC DATE: 11105104 13:19 <br /> PRODUCT TAX: 0.07750 LODI CA 95240 <br /> PHONE 209-365-6077 <br /> PIRMASE ORDER# TAX EXEMPTION NEIR: <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT OTY WIT PRICE TAX CHANGE <br /> SERIAL# <br /> 100009 FUEL FEE SUCHARGE 1 8.1500 0.00 8.15 <br /> 90030 MODEL 90 W12370 8 6317 1 216.0000 16.74 232.74 <br /> 21025 CLEAN 5 SPENT 0 <br /> SERVICE TEAM 12 <br /> - ------------------------------- <br /> TOTAL SERVICEIPROUCTS 224.1500 16.74 240.89 <br /> USEPA TRANSPORTER 1 1)(ROo0050930 (F)ERATOR USEPA CAL000241686 <br /> USEPA TRANSPORTER 2 GENERATOR STATE <br /> MANIFEST DOC W 24114711 FORM CODE 10 <br /> US DOT DESCRIPTION (INCLUDING PROPER SHIPPING MANE, HAZARD CLASS, AND 10 <br /> USED CLEANING COMI)OIN)S, N.D.I.B.N. <br /> LIQUID (NIT USOOT OR USEPA REGULATED) <br /> AQUEOUS PMTS WASHER SOLUTION! (8.3WGAL) <br /> TOTAL CONT i TYPE ON TTL OTY 22 LIMIT WTIVOL G SOOT 941 <br /> CONTAIN R#41009082753 OTY 22 WASTE CODE CA 134 <br /> DESIGNATED FACILITY NAMEIADO ESS: <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 5050 SALIDA BLVD <br /> SALIDA CA 9M <br /> USEPA ID N7 CAT000613968 TOTAL CHARGE 240.89 <br /> STATE 10 NO CATOOD613968 WASTE MIN 0.00 <br /> TOTAL DUE -------240.69 <br /> UNPAID BALANCE THIS RECEIPT 240.89 <br /> Machine clean and good midi tion? Yes <br /> Deals in place and legible? Yes <br /> Fusible link installed? Yes <br /> Emergency closing of lid unobstructed? Yes <br /> Machine properly grounded? Yes <br /> Spent solvent meets acceptance criteria? Yes <br /> Prop 65 wring (Calf. only)? Yes <br /> GENERATOR STATUS 0 - 220 Ibslmonth <br /> The generator has established a program to reduce the volume 0, <br /> quantity and toxicity of the hazardous waste to the degree, as determined <br /> by the generator, to be economically practicable. <br /> Customer certifies that (I) the above-named 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 /> Department of Transportation and (ii) no material 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 baud by the teres and midi tions (1) set for lh in (a) <br /> the General Terms and Conditions provided separately to Customer or <br /> (b) any SK agreement signed by Customer and SK, and (2) incorporated <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section. SK is authorized to charge Ccs toner's account for this <br /> transaction. Customer certifies that the individual signing this Service <br /> Acknowledgement is duly authorized to sign and bind Customer. <br /> IN THE EVENT OF M EMERGENCY! CALL 1-800-468---1117766600(��•/((2244 hours) <br /> X � � <br /> SIGRA TURE NAME: MATT WAGER <br />