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4' �• 7142 24 David 8uxtoo ",/07/12 14.2 A6E 1 <br />Safety-K7e n Systems, Inc. <br />5360 Logacy Drive, r*' <br />Building 2. Suite 100 <br />Plano, Texas 75024 <br />800-665-5740 <br />209-545-1011 <br />REFERENCE RBC. <br />CUSTOMERN 10130745 CAL -TRANS SHOP 10- 30110 NC 5361 42 � <br />1603 S 8 St SRW WEEK: 2012-31 <br />Stockton CA 95206-2476 SAW DATE; 06/07/12 14,2E <br />E209-948-7813 <br />BILL TO CUSTOMER# BILL TO ADDRESS: <br />0010130745 CAL -TRANS SHOP 10- 30110 NC <br />1603 S R St <br />Stockton CA 95206-2476 <br />PHON9209-948-7813 <br />PURCHASE ORDERS s301-254 TAX OR <br />PRODUCT/SERVICES <br />SM CE/ TOTAL <br />PRODUCT QT1 UNIT PRICE TAX CHARGE <br />X 83635 WASTE SGL BRKE SMAVNG> 4.000 0.0000 0.00 0.00 <br />SERVICE TERM 24 WEEK <br />t # <br />COTS: 4 TSOF: 7401 MANIFEST*: 18642 FORM CD: BL SK SMV* 207990407 <br />:CNT4: 120802280253'. QTY:: $0 WR/VOL.P PROFILE: 0150176 SKOOT 14078 <br />fkT*: 120802280252 QTY: $O W6/VOL P PROFILE, 0150175 SOOT 14078 <br />CNTO, 111011772209QTY: 30 VrML P PROFILE, OLS0176 SKDOT 14078 <br />$Mrs., 111011772210 QTY; :30 Vr)%40L P PROFILE: 0150176 SKDOT 14076 <br />3635 BRAKE SHAkT Z SGL 4.005 ill.Gow 0100 444.00 <br />SMNICE TERM 24 WEEK <br />100001. FEE, FUEL SURCHARGE 1.000 :.:15.4600- 0,00 15.46: <br />TOTAL SERVICE.. ..____126.4600 - 0.'0.00 __-450.46 <br />t <br />f TOTAL CHARGE . 459.E <br />! <br />CREDITS 4.00 <br />--+- <br />TOTAL DUE 459.46- <br />AMOUNTRAW CREDIT CARD 459.46 <br />VISA ACCrfXXX0L-XXXk-)0=-O933EXP. DATE 8/13 <br />UNPAID BALANCE THIS RECEIPT 0.00 <br />GENERATOR STATUS <br />0-220 lbs/mooth <br />Custer certifies that (i) the alcove -aa td oaterials 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/material or in the process i <br />generating the waste/mutterial. Customer .agrees to prythe above <br />charges and to be bound by the term and conditions (i) set forth in <br />(a) the 'General Terms and ;Conditions provided separately to Customer <br />or 0) any SK agreement signed by Customer and SK, and (2) <br />incorporated herein by reference. ,Unless otherwise indicated in the AV <br />payment received section. SK is Authorized ta'charge Customer's <br />account, for this'tran%acti+aa. Customer certifies that the individual <br />signing this Service Acknowledgement is duty authorized to sign and <br />bind Customer. The following provision is Applicable to Safety -gleans' <br />parts cleaner and paint "a cleaner services: ,Custom r agrees that it <br />will not introduce any substance into the solvent or Aqueous cleaning <br />solution, including without limitation any hazardous waste or <br />hazardous waste constituent, except to the extent such introduction is <br />incidental to the normal use of the sachine. Customer further agrees <br />that it will not clean parts/paint;_guns that have been contaminated <br />with or otherwise introduce polychlorinated ;bipbenyls QaCB`s), <br />herbicides. pesticides, dioxins or listed hazardous waste into the <br />selvant or "&am* cleaving solution. Safety-Kleen has the capacity <br />and is permitted' to accept, store, and/or reclaim the spent parts <br />washer solvent; paint thinners, solvents and paints generated by <br />customer; or dry :cleaning filter cartridges. powder. and still <br />residues containing perckloroethylens. petroleum naphtha, or, <br />triflurotrichloraotha"t dry cleaning solvents. Safety -Veen and <br />customer agree that this agreement is intended to satisfy the <br />requirements of 40 CFR 262.20(e), IN THE EVENT Of AN EMERGENCY CALL 24 <br />MR EMERGENCY 6 1-800-468-1760 (Safety-Kleeo Contract p 94138) <br />X <br />CUSTOMER / GENERATOR: Thomas Dailey <br />LAST PACE <br />