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BRANCH 718501 CSG 25 FLOES,PATRIO( 04121105 13:11 PAG- 1 <br /> Safety-KI 1 <br /> 5400 Legacy Dr. <br /> Cluster II, Building 3 <br /> Plano, Texas 75024 <br /> 209-545-1011 <br /> REFERENCE ifBR <br /> CUSTOMER# 2225819 END OF THE LINE AUTO RPR 0028771319 <br /> SERVICE TAX: 0.07750 200 CMERCE #101 SRVC WEEK: 05-16 <br /> ONS TAX: 0.00000 ME DATE: 04121105 13:07 <br /> PRODUCT TAX: 0.07750 LOM CA 95240 <br /> PHONE 209-365-6077 <br /> PURCHASE ORDER# TAX EXEMPTION NBR: <br /> PRRV ILEI PRODUCT/SERVICES TOTAL <br /> PRODUCT DIV UNIT PRICE TAX CIARbE <br /> SERIAL# <br /> 100009 FUEL FTE SURGWLGE 1 8.1500 0.00 B.15 <br /> 90830 MODEL 90 W12370 8 6317 1 216.0000 16.74 232.74 <br /> 21025 CLEAR 5 SPENT 0 <br /> SERVICE TEAM 12 <br /> TOTAL SENVICEIPROIKTS 224.1500 16.74 240.89 <br /> USEPA TRANSPORTER I TXR000050936 GENERATOR ISEPA CAL000241686 <br /> USEPA TRANSPORTER 2 GENERATOR STATE <br /> MANIFEST DOC #24251847 FORM CODE 1D <br /> US OOT DESMIPT ION (INCLUDING PROPER SHIPPING NAE, HAZARD CLASS, AD HD <br /> USED CLEANING COMPOUNDS, N.D.I.B.N. <br /> LIGUID (NOT USDOT Of ISEPA REGULATED) <br /> AULEOS PMTS WASHER SOLUTION (8.3#M) <br /> TOTAL CONT 1 TWE ON TTL OTY 18 UNIT WTIVOL 6 SKOUT 941 <br /> CONTAINER#50326084156 OTY 18 WASTE CODE CA 134 <br /> DESIGNATED FACILITY NAICMO1AE5S: <br /> SA ETV-KLEEN SYSTEMS, INC. <br /> 5050 SALIDA BLVD <br /> SALIDA CA 95368 <br /> ISEPA ID NO CAT000613966 TOTAL CHARGE 240.89 <br /> STATE ID NO CATOOM13968 WASTE MIN 0.00 <br /> TOTAL DUE 240.89 <br /> UNPAID BALANCE THIS RECEIPT 240.89 <br /> Machine clean and good condition? Yes <br /> Denis 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 warning (Calf. only)? Yes <br /> GENERATOR STATUS 0 - 220 I6slmanth <br /> The generator has established a program to reduce the volume or <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-rawd materials are properly <br /> classified, packaged, marked and labeled, and are in proper condition <br /> for transportation according to the app]!cable regulations of the <br /> Department of Transportation and (ii) no material change las 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 terms and conditions (1) set forth in (a) <br /> the General Terms and Conditions provided separately to Customer or <br /> (b) any S( agreement signed by Customer and SK, and (2) incorporated <br /> herein by reference. Unless otherwise irdinted in the payment <br /> received section, SK is authorized in charge Customer's accoorl for this <br /> transaction. Customer certifies that the individual signing this Service <br /> Acknowledgement is duly authorized to sign and bind Customer. <br /> The following provision is applicable to Safety-Kleen's parts clearer and <br /> paint gun cleaner services: Customer agrees that it will not Introduce any <br /> substance into the solvent or aqueous cleaning solution, including without <br /> limitation any hazardous waste or hazardous waste constituent, except <br /> to the extent such introduction !s incidental to the normal use of the <br /> machine. Customer further agrees [hat it will not clean parts/paint guns <br /> that have been contaminated with or otherwise introduce polychlorinaled <br /> biphenyls (PCB's), herbicides, pesticides, dioxins or listed hazardous <br /> waste into the solvent or aqueous cleaning solution. <br /> IN THE EVENT OF M EMERGENCY CALL 1-800-468-1760 (24 hours) <br />