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06/01/18 13:09 PAGE t <br />Safety-Kleen Systems, <br />2600 N Central Espy, Suits 200 <br />Richardson, TM 75080 <br />CORPORATE: 800-669-5740 <br />24 MR EMERGENCY: 800 -468 -IMO CSafaty-KI <br />2095451011 <br />REFERENCE NBP. <br />CUSTOMERS RE18372 Ria Coontry 76972488-1&02696950 <br />1515 N Main St SRVC WEER: 2018-22 <br />Menteca CA 95336-3243 SRVC DATE: 06/01/18 <br />PHONE 999-999.9909 <br />WILL N CUSTDMERI RILL TO ADDRESS: <br />1I111372 Mia Country <br />1515 N Main St <br />Manteca CA 95336-3243 <br />PHONE 999-699-9909 <br />PURCI ASE ORDERS TAX EXEMPTS <br />PRODUCT/SERVICES <br />SITOTAL <br />PIIGdU(:TOOD[T OTY ONLr PRICE TAX CHANCE <br />33x3 USERVIC GAL FOR O.E. 3.000 $.ODOO 0,00 3.00 <br />SERVICE TERMWASTE <br />13 O.F.WEEKY331R USER S5 WASTE . 2.000 0.0000 0.00 0.00 <br />SERVICE TERM 12 WEEK <br />CAUSE COO! VoidLineine -WASTE PICKUP ONLY <br />8"4e0 CRIOIL F2 E)0 S]G 1.000 0.0000 0.90 0.00 <br />SERVICE <br />CE 7TERMli WEEK <br />3247404/ CAUSE CODE VoidReaderAndi.ine -SERVICE NOT NEEDED <br />875000 FR1-LVD FOR FUEL SSfd. 1.000 0.0000 0.00 0.00 <br />SERVICE TERM 12 WEEK <br />944502/ CAUSE CODE VoidHeade rAnditine -SERVICE NOT MEMO, <br />MD_hQN <br />875.160 tSERVIC NTENNOUS EEK 5 1.000 0.0000 0.00 0.00 <br />SERVICE TFAM a NEER <br />911505/ CAUSE CODE VoidNeaderAndLine -SERVICE NOT NEEDED <br />8211143 CCS 56L CHAR SOL/SEMI STA 1.000 0.0000 0.00 0.00 <br />SERVICE TERM 12 NEER <br />CAIS! CODE VoidLine -WASTE PICKUP ONLY <br />8 tYltl CS: 1 IwF: L NNiItbIA: OOYS209105a5 FORM CV: US SMlPe tzbsub" <br />018: 18052460953 Q'IY: 30 WI/VUL P PMQF9 94A05 5K001 2572215 <br />11£5741/ <br />875-182 005 XSGL NON HA2 StMI SL 1.000 0.0000 0.00 0.00 <br />SERVICE TEAM 12 WEEK <br />CAGE CODE VoidHeaderAndtine -SERVICE NOT NEEDED <br />911847 MODEL 90 W/2387 i 5365 1.000 109.0000 8.99 117.99 <br />SIN 331301" IAO 50031/05x13130188 CLEAN 2.56 SPENT 0.000 <br />SERVICE TERM 12 WEEK SCANNED YES <br />1O01A1 FEE, FUEL SURCHARGE 1.000 0.0000 0.00 O.OD <br />3230 TAX NAIOLINO M/C OWN UMW 30 1.000 0.0000 0.00 0.00 <br />-_-'..............."..___.__ <br />TOTAL SERVICE/PRODUCIS 114.0000 8.99 122.90 <br />TOTAL CHARGE 122.90 <br />CREDITS 0.00 <br />--'-------'-'-- <br />TOTAL DTIC 122.99 <br />UNPAID BALANCE THUS RECEIPT <br />:iny of lid unobstructed? Yes <br />Aly 9roonded7 Yes <br />m. Sticker Affixed to Machine Yes <br />mreto acceptance criterl&7 Yes <br />GENIRATUR STATUS <br />0-).'d0 lbs/mouth <br />Cox taller Alrt.ifio that Ci) <br />clal.a i(ied, yack"ed, nprkad <br />r.r Iranelmrtation a"erdiny <br />hr <br />I. er TIrA1cc+xr;.L;n <br />eiNmr In the 'h. Lefies eel. <br />ye N:fal iny 111E MaSle/Ilpterla <br />Gm•:,.ter States is wrraLL. <br />and to be bound by We t<nm <br />Gen.rral Tenure alnl Condition. <br />any S1 .0 At siUncJ by C <br />1ein by r.rerance. Do... <br />Zeloed ..,Liao. S1 I. aelh <br />thi,. tran.action. Ircoolmn. <br />anonnt equal to that teaser u <br />I'- about-nanmd slater ialb are properly <br />and labeled, nod are is proper andiLiun <br />to ❑Iw ayyli'able ratuulat imm or W. <br />CFI) nac.ial 'h.aye hu . .Ad <br />of the este/m.terial or I.. the FI.L s. <br />and (Ili) U,..b... ,xr.,x.,xd <br />Co.luner .11ca to Pay LFI, be,. cFxx,oa <br />and condi Lions (1) set ForLb in (,V the <br />prllvidul separately to Costumer or (b) <br />.tuner and SK, and (2) 1 ... ryoraled <br />other. 6a indi'aled in the paMment <br />rued to 'k.". Cn.t.."x au.ont Por <br />fells to make P.Mlent Shen du., an <br />(b 1.5% Par nenth CIS% per annulD or <br />.knuwledyesent is duly .uthoriaed to sio umJ bioJ <br />Ener wckuowldy<a that it is re>yuna ible Por rain la in iny <br />taln. and obtaining all EPA ID number If reyo Fred by <br />-)he FullawinY Provision is ayyTicable to <br />Portz cleaner and Paint Van 'lcaear .... ic.s: Cadaver <br />.ill out istroJu'e ally subslancc into the s.lvenl or <br />IU aviation, Fa11oJh,1 aiLhunt 11.4tation any h..rd..x <br />lues was to canatitoenl, except to Lim ..lent sorb <br />iOe iJ en Lal to the nmo,al oae of the np'hiue. Cuatoseee <br />that It will not ❑. rt./Paint uen. that Lava b.au <br />