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Ile 1301 Gervais Street - Suite 300DUNS "' 71-p,7 R�P§Rto SEN -�Mfo F NO. 05-397-6551 FED. ID NO. 396090019 CUSTOMER IrI5-195-8487 pild Columbia, South Carolina 29201 FOR SERVICE CALL BRANCH MA MANAGER. DOC. EXP. I SCHEDULED SERVICE WEEK SCHEDULED I TERRIo HE UL'ED T RIP satmill-bleen. CUSTOMER NO. MSDS (FROM ABOVE) PR DU CT .7 NIRIBER UNIT PRICE TAX CHARGE I CC I MIN. ICLFANISPENTIC*O'N'T.1 SK TERM SCH SERVICE TERM *— (WEEKS)(INITIAL) " NO. NLLLA SL NO 0g 545 11( 1IRALPH TOR ES L8123/03 03--26 101 0(je3?573e5 C 3 U 0 1 0 7 0 1 9 0,001 1 1 11 441 4 1 CREDIT PREVIOUS BALANCE CODE BAL. OVER 60 D—AY-T— E 16394*34 11817,76 S CAL TKANZs Nf1Qfj 1LJ 00oa-3854-67 T CATUDLJ613�168 CAL TRANS - DIVISION TEN BUSINESS TYPE P OUTER CHAIN COUNTY SVC. P/C PROD. P/C M 1603 S S ST CATU00613-16h PO BOX 1632 06 0 0 N 0 1946 3 0 0 Q I E, EQUIP DIVISIONSTOCKTON ® CA'95206 LOCATION TAX EXEMPTION NO. R S: T 0 C K TKI 0 r 9-spos SERVICE DATE I SALES REP No. CUSTOMER P.O. NUMBER CUSTOMER PHOINIE# TAX CODE HANDLING ASSOC. CODE CODE SERVICE TAX C.O.M.&TAX I PRODUCT TAX .GOOD POOR DECALS IN PLACE IONAll LEGIBLE LINK FUS T BLE INSTALLED ❑ EMERGENCY CLOSING OF LID UNOBSTRUCTED YES NO YES NO MACHINE PROPERLY GROUNDED E] LOCAL PHONE NO. STICKER ❑ ❑ AFFIXED TO MACHINE ❑ SPENT SOLVENT MEETS ❑ ACCEPTANCE CRITERIA Z LU, TOTAL141 .UANTITY WTNOL UNIT SK DOT NUMBER TOTAL-SERVICE/PRODUCTS M M=1 'ROPRIATE MACHINE CONDI BOXES & CLEANLINESS LAMP ASSEMBL CONDITION 64(PORANVS TER,"i I "' 71-p,7 R�P§Rto SEN -�Mfo F 3eAUL129 09-948-7814 IrI5-195-8487 pild 0?75 DEPT SERVIC E L R 1-1- A L REMARKS/ QUAN. CHARGE SALES TOTAL I WASTE SOILVEINIT/DRUMS� SERVICE I E CHANGE 'KANGE w PROMO INV. MSDS (FROM ABOVE) PR DU CT .7 NIRIBER UNIT PRICE TAX CHARGE I CC I MIN. ICLFANISPENTIC*O'N'T.1 SK TERM SCH SERVICE TERM *— (WEEKS)(INITIAL) " NO. NLLLA SL NO GIVEN 100 1 c 1 0001977--3 11l 94.501 7,32 101.82 0,001 1 1 11 441 4 1 El TOTAL-SERVICE/PRODUCTS M M=1 'ROPRIATE MACHINE CONDI BOXES & CLEANLINESS LAMP ASSEMBL CONDITION 64(PORANVS TER,"i I "' 71-p,7 R�P§Rto SEN -�Mfo F TXROD0050930 ICAD9182501736 HYHQ36020740 11. US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID.) USED CLEANING COMPOUNDS, N.0.1.90-,4. LIQUID CNOT USDOT OR L1r'i'&—PAAk _R16L)LATED) AQUEOUS PARTS WASHER SOLUTIO N (8.3 GAL) GREATER THAN 2,200 LBSJVONTH —j — < c' Jr LL) E DESIGNATED FACILITY NAME AND ADDRESS SAFETY .-KLEEN -5'-,3SO— SALIDA BLV SALLA SYSTEM§ -i -1N -CE—* CA 95368 CASH LJ TOTAL RECEIVED APPLY PAYMENT TO: CHECK NUMBE,R ❑ TODAY'S SERVICE/SALE 3 ❑ PREVIOUS BALANCE AS FOLLOWS LDR MES INVOICE # AMOUNT$ INVOICE # AMOUNT$ L D R NOT ... .. .. I--, - I— MANIFESTCODEI CREDIT _ 002175732S B2 C000-37' 1`1 C toers Authorized RepreSentative � 4 TOTAL CHARGE (FROM ABOVE) L) cl. > ❑ 0 GREATER THAN 2,200 LBSJVONTH —j — < c' Jr LL) E —D DOCUMENT IS DULY AflTHORIZED To SIGN AND BIND CUSTOMER TO ITS TERMS. 'Th is Is to canny that Id wified. packaged, madmd and tab (FROM ABOVE) MCI M!� .�v proper diiianio n�portationn_di�'g-!A:':="'u.o..i...p..,ofTromponation.- ffe'-'j I -j v El SEQ # INITIALS 11 ICERTIFY THAT NO MATERIAL CHANGEHASOCCURRED EITHER IN THE CHARACTERISTICS USA E PAIDNO. CATUDLJ613�168 Z -6 'F THE WASTE El MATERIALS OR IN THE PROCESS GENERATING THE WASTE MATERIALS. STATE ID NO. CATU00613-16h UJ (c ❑ .GOOD POOR DECALS IN PLACE IONAll LEGIBLE LINK FUS T BLE INSTALLED ❑ EMERGENCY CLOSING OF LID UNOBSTRUCTED YES NO YES NO MACHINE PROPERLY GROUNDED E] LOCAL PHONE NO. STICKER ❑ ❑ AFFIXED TO MACHINE ❑ SPENT SOLVENT MEETS ❑ ACCEPTANCE CRITERIA Z LU, TOTAL141 .UANTITY WTNOL UNIT SK DOT NUMBER 5 1613 0 5 5 I CERTIFY THAT My TTAL WASTE STREAMS ARE WITHION ONE 09 THE FOLLOWINC CATEGORIES. W rdy Z 6 941 OTO 220 LBS./MONTH.0 INITIALS 220 L 8. 0---00 SJMONTH 002175732S B2 C000-37' 1`1 C toers Authorized RepreSentative � AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TERMS AND CONDITIONS. SET FORTH ABOVE AND ON THE REVERSE SIDE OF THIS DOCUMENT -FOR TOTAL CHARGE (FROM ABOVE) L) cl. > PLEASE CHARGE MY ACCOUNT THIS TRANSACTION UNLESS OTHERWISE INDICATED IN THE '4YMENT RECEIVED SECTION. THE INDIVIDUAL SIGNING THIS GREATER THAN 2,200 LBSJVONTH —j — < c' Jr LL) E —D DOCUMENT IS DULY AflTHORIZED To SIGN AND BIND CUSTOMER TO ITS TERMS. 'Th is Is to canny that Id wified. packaged, madmd and tab (FROM ABOVE) MCI M!� .�v proper diiianio n�portationn_di�'g-!A:':="'u.o..i...p..,ofTromponation.- ffe'-'j I -j v TOTAL DUE SEQ # INITIALS LC c ICERTIFY THAT NO MATERIAL CHANGEHASOCCURRED EITHER IN THE CHARACTERISTICS USA E PAIDNO. CATUDLJ613�168 Z -6 'F THE WASTE MATERIALS OR IN THE PROCESS GENERATING THE WASTE MATERIALS. STATE ID NO. CATU00613-16h UJ (c 002175732S B2 C000-37' 1`1 C toers Authorized RepreSentative � AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TERMS AND CONDITIONS. SET FORTH ABOVE AND ON THE REVERSE SIDE OF THIS DOCUMENT -FOR TOTAL CHARGE (FROM ABOVE) L) cl. > PLEASE CHARGE MY ACCOUNT THIS TRANSACTION UNLESS OTHERWISE INDICATED IN THE '4YMENT RECEIVED SECTION. THE INDIVIDUAL SIGNING THIS WASTE MIN. Jr LL) E —D DOCUMENT IS DULY AflTHORIZED To SIGN AND BIND CUSTOMER TO ITS TERMS. 'Th is Is to canny that Id wified. packaged, madmd and tab (FROM ABOVE) MCI .�v proper diiianio n�portationn_di�'g-!A:':="'u.o..i...p..,ofTromponation.- ffe'-'j I -j v TOTAL DUE SEQ # DO NOT WRITE IN THE AREA BELOW Print Custbmer Name 002175732S B2 C000-37' 1`1 C toers Authorized RepreSentative �