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uD�41/Lu10 'i'U>; 10: 1u EIRA IQ,�u UL/11u La <br /> �J <br /> CSG SK-SSL-BOX-23 David L Buxton 02/23/16 15t23 PAGE 1 <br /> afety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX IS080 <br /> CORPORATE: 800-669-5740 <br /> 24 R EMERGENCY; 900"4691760 (Safnt.y-Klnnn) <br /> 2095451011 <br /> REFERENCE NPR. <br /> CUSTOMER# 8021038 Bobs Lube 6 smog 69339803 <br /> 1403 Country Club Blvd ERVC WEEK: 2016-8 <br /> Stockton CA 95204-4910 SRVC DATE: 02/23/16 15:21 <br /> Piton 209-943-3633 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> 8022519 Boby Lube 6 Smog <br /> 1403 Country Club Rlvd <br /> Stockton CA 95204-4910 <br /> MoNt 209-9433633 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> RRRVTC,R/ TOTAL. <br /> PRODUCT QTY UNIT PRICE TAX CHARGE. <br /> 95 <br /> 98800 AQl SERVICE WITH 6365 1.000 29'I.uSuU 23.76 320.81 <br /> SIN 90300011 TAG 00098000SK09030005 CLEAN 1,00 SPENT 0,000 <br /> SERVICE TERM 12 WEEK SCANNED YES <br /> 100001 FEE, FUEL S RCIIARGE 1.000 9.2200 0.14 9.95 <br /> --------------------------------------- <br /> TOTAL, S£R T.CE/PRODUCTS 306.2700 24,50 330.77 <br /> TOTAL CHARGE 330.77 <br /> CREDITS 0.00 <br /> TOTAL DUE - 330 77 <br /> --------------- <br /> UNPAIrI RAIANCF THTB RFCFIPT 330.77 <br /> Machine clean and goo condition'? Yea <br /> Lamp Assembly Conditl n Yes <br /> Decals in place and 1 Bible? Yes <br /> Fusible link installs ? Yea <br /> Emorgenry cloning of id unobstructed? Yea <br /> Machinc properly grow drd? Yra <br /> Local Phone No, Stick r Affixod to Machine Yoe <br /> Spent solvent meets a ceptonce criteria? Yos <br /> GENERATOR STATUS <br /> 0-220 lbn/mnnt.h <br /> Customer certifies that (1) the above-named mat.er.lal.y are properly <br /> classified, packaged, marked and labeled, and are in proper cundition <br /> for transportation according to the applicable regulations of t,hr <br /> Department or Transportation and Ili) no material change ha3 occurred <br /> el�her in the charact riatics of the waste/material or in the process <br /> generating the womtte/lyteriel. Customer agrees to pay the above <br /> charges and to be bound by the tenni end conditions (1) get forth in <br /> (a) the General Terms and Condi.t.lon, provided neparately to Customer <br /> or (b) any SK agreeme t signed by Customer and SK, and (2) <br /> incorporated herein b reference. Unless otherwise indicated in the <br /> payment received sect on, SK is authorized to charge Customer's <br /> account for this transaction, If customer tails to make payment when <br /> due, on aluounL equal lo the leaser of (i) 1.S% per month (18% per <br /> annum) nr (JA) t:hc ma imuln amuuh(: dllowed by law, will be added to all <br /> :lnpmid amnunt.s nuh.Rt%M ding, Cunt.omer cerLlfles that the individual <br /> signing this: Service rknowlndgemtenh it duly authorized to sign and <br /> bind Customer. The following provi,eion io applicable to Sarety-Kleen's <br /> parts cleaner and psi. t gun cleaner aarvicea: Cuatnmer agrees that it <br />