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T <br /> BRANCH 7142 CSG 27 dbuxton, o2/07/12 10:43 PAGE 1 <br /> Is• <br /> Safety- leen Systems, Inc. <br /> 5360 Legacy Drive. <br /> Building 2. Suite 100 <br /> Plane, Texas 75024 <br /> $00-669-S740 <br /> 209-545-1011 <br /> REFER , <br /> IOMLNi 30alt'" It:1CHtK1 CONS1RUCf10N 5/191/30 <br /> 120 Frank West Cir ERVC WEEK: 2012-6 <br /> Stockton CA 95206- 3 SRVC Dalt: 02/07/1t 10:42 <br /> PHONE 916-82$-8269 <br /> BILL TO CUSIOMENM BILL 70 ESS: <br /> 0003083528 'FLILl1ERf C TRILLION <br /> Po Box 15002 <br /> AT1N PETE SANTOS <br /> Sacramento CA OSSSI-0002 <br /> PURCHASE ORDER6 TAX EXEMP I'LON NOR Y <br /> PRODUCT/15-VERVICES i <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 250101 MODEL 2SO W/ASDL 1.000 0.0000 0.00 0.00 1 <br /> S/N 6013443 tAG 001105 013443 CLEAN 83 SPtN1 0 20 <br /> SERVICE TERM 16 WEEK SCANNED YES 40 <br /> 6660 Q-SOL 300 PER GALLON 11.000 35. 50.80 415.80 90 <br /> SERVICE TERM 16 WEEK <br /> • <br /> 3360 DRUM, 30 GL BLUE SlEtl AQ 15.000 0.0000 0.00 0.00 <br /> SERVICE TERM 16 WEEK <br /> 3t3O FAX"ANDLIM N/tORM IXIOP 30 2S.U1)O 0.0000 0.00 U.09 <br /> 28111001 FEE, FUtL SURCHARGE 1.001) 1611200 1.29 11.41 <br /> TOTAL StNVIC'E 11C rs S1.1200 32.09 433.21 <br /> sea0 <br /> TOTAL CHARGE 433.21 <br /> CREDITS 0.Do <br /> TOTAL DUE -------433.21an <br /> -- <br /> UNPAID BALANCE TRIS RECLIPY 433.21 <br /> 44 <br /> Machine clean and Mood condition? Yes <br /> Loop Asseardely Condition Yes <br /> Decals in place and legible?Yes <br /> Fusible link installed? Yes 4j• <br /> ErrwrVency closing of lid unobstructed?Yes <br /> Machine properly grounded? Yes 41 <br /> Local Phone No. Sticker Affixed to Machine Yes 411 <br /> Spent solvent wets acceptance criteria? Yes •0 <br /> REGEI1 <br /> All <br /> OCT Z014 <br /> { GENERA STATUS <br /> 0-220 lbs/month go <br /> NO <br /> Cost.,..- certifies that (;) the above-nw,ird uwter•ials are properly <br /> ENVIRONMENTAL classified' packaged. urar•ked nal labeled, aril art in proper Condition at <br /> 1� f� T"flA�hl"s fur transpartation according to the applicable regulal'ron% of the <br /> Department of Trarupurtaliun n <br /> told (i;) ou wter•ial chanye has occurred <br /> '- either in the charreter isl ics of lite v;asle/nralce•ial or it. the pr'ucrss <br /> generating the waste/nwlerial. Cusluurer agrees to pay the dhove <br /> charges and to be bound by the tervus and tond;1.61ts (1) set forth in a <br /> (a) the General Tereus aced Conditions pruviolcd separately to Custaiter <br /> or (r) any SK agremuent signed by fustunwr and SK, and (2) <br /> iocurpor•tttd herein by rtfer•entt. Unless ulhe+wise inditaled in lire <br /> paynrerrt received section, SK is aulhurixed to .:har•ye Custaner•'s <br /> account for this transaction. CksLainer cerlef;es that the individual <br /> siVu;ng this Strvice Acknuwledyemeol is daily a Lhurieed to sign and <br /> bind Custoomr. The fulluwiny provision is 6PPl;cable to Safety-Kleen's <br /> t!�+•<.+ •lrwnrn rw.r t...int ,+...,. .Ir+a,w,• .r.••l•ae• �w�ee••w•r a.,rr.•+ !/.!ea :0 <br /> will not inlruduce any substance into the solv.:nl ur aqueous cleaning <br /> solution, including without limitation any hazardous waste or <br /> hitar•duus waste Luustituent• excepL to the extent_ such enlruduLtion is <br /> ;.L..t.t r.. tL> ...,o.l ­. ,.f U.r „w..1,:... r...e..,.... F..rt h..• _ O <br /> that it will not clean parts/paint guns that have bteo L•rltdnindled V <br /> with or otherwise introduce polychlorinated biphenyls 's), <br /> hcr•b;Lides, pesticides, dioxins or listed hatdrduus waste into the C <br /> solvent or aqueows clearing solution. Safety-Kleen has the Lapacity <br /> and is pennitltd to accept, store, mad/or reLlaine the aPent parts r <br /> washer solvent; pa;ort thinners, solvents and pd;nts generated by <br /> custoneer; or dry cleaning filter cartridges, powder. and still <br /> residues containing pera.hloruethylene, petr•oleean naphtha, or 01) <br /> tr•iflurulriLleloroetlaane dry cleaning solvents. Safety-Kleen and RI <br /> custaarm' agree that this agree—ut is ialtnded to satisfy the 46• <br /> requiranents of 40 mt 2bt.20(e). IN LAE tVENI OF AN tMEHGENLY CALL 14 <br /> HR EMERGENCY 4 1-900-468-1760 (Safety-Kleen Contract t 94138) <br /> a <br /> CUSTOMER /GENERA :David Davidson <br /> i Alc R- nsY"ar <br />