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Dec, 30, 2019 10.20AM No. 0317 P. 1 ' <br /> CSG SK-SSL-VAC-42 PA"i ,in 0 Taylor 12/12/19 1A107 PAG) <br /> Safety- M eon Systems, Inc, <br /> 260D N Central Expy, Suite x60 <br /> Richardson. TX 75060 <br /> CONpORA'R: 800.640.5740 <br /> 34 HR CHI;RQENCYI eO0-46a-1768 (04faty-Hleen) <br /> x095/51011 <br /> REFERENCE NEI <br /> CUSTOHERP CA39981 Cal Wast concrete cutting DISR4030-10064DAZI <br /> 1153 Vanderbilt Cir SRVC WEER: 2019.1 <br /> Manteca CA 05317.0120 SRVE DAYS: 12/12/1 <br /> PHONE 200.923-2236 <br /> BILL TO CUSTOMERO BILL TO ADDRESSI <br /> CA39905 Cal West Concrete Cutting <br /> Li53 Vanderbilt Cir <br /> Manteca CA 05237-0120 <br /> PH"f no-833-3776 <br /> PURCHASE ORDER# Shop TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SF3IVICR/ TOTAI <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 10307 YAC SERVICR FEE AUTOMOTIV 1,009 504,0000 0.00 304.0( <br /> SERVICE TERM 52 WEEN <br /> 60667 VACUUM LigUYD 00.FQUAL) 770.000 0.0060 0.00 0.01 <br /> SERVICE TERM 24 WRFM <br /> HALOGEN/CLOR,D-TECT TEST RESULT PASS: PPA K 1000 <br /> VAC PH TEST: d <br /> 46077 VACUUM SOLID Q40N-PQUAL) 730.000 0.0000 0.00 0.01 <br /> SERVICE TERN 24 WEEN <br /> HALOGEN/CLOR-O-WCT TEST RESULT PASS: PPM A 1900 <br /> YAC PH TEST: 6 <br /> 0 CONTS: 1 TSDF1 RUG MANIFESTS: 24036 FORM Cot EL SHIP#21D140105 <br /> CNTle 191;12536193 QTY: 1540 WTNOL G PROF#156097 SEOOT 3200 <br /> 100030 RECOVERY FEE 1.000 50.500D 0.00 au.51 <br /> 10908 VAC SVS SERVICk FOE 1.000 . 807.0000 0.00 693.0( <br /> 10913 UAC TRUCK WASH 1.000 200.0000 0,00 300,01 <br /> 62118 HALOGENS TEST 1.000 120.0000 0,00 120.0( <br /> 1UP75 FEC, VAC SON SOLIDS 1500,000 1.6600 0.90 0520.41 <br /> 10024 FOR, VAC aLEEN DRAIN SIN 2,000 174.0080 6.00 348.01 <br /> - <br /> TOTAL SERVICE/PRODUCTS 1673.1800 0.00 4365,51 <br /> TOTAL CHARGE 4765.50 <br /> CAEOIlS 0.00 <br /> TOTAL OUR -- - "4365.50 <br /> UNPAID BALANCE THIS RECEIPT 4265.50 <br /> per gOG M420"001 the halogeh detecting instrument has been <br /> zeroed and validated. <br /> OeNhHATOR STAiUS <br /> CE54Gs Vehisld <br /> customer certifies that (i) the above-nomad matariaii are properly <br /> classified, PAckeged, marked and labglod, and are in proper condition <br /> for transportation according to the applicable regulations of the <br /> Department of Trohzportation (ii) no material change has occurred <br /> + either in the characteristics of the waste/material or in the process <br /> generating the wastafmaterial, and (iii) the above referenced <br /> Generator Status is correct. Customer appraos to pay the above charges <br /> and to be bound by the terms and cohditions (1) set forth in (o) the <br /> General Term% and Conditions provided separately to Customer or (b) <br /> any SR agraFment signed by CYxtgmar, and SE, and (2) incorporated <br /> herein by reforonco, Unless otherwise'indicated in the payment <br /> received ■ertion, SH is aothorieed to charge Customer's accouht for <br /> this trtnsaetion. if Customer fails to make payment whin due, an <br /> Amount equal to the lgssap of (i) 1.5%par month (161{per annum) or <br /> (ii) the maximum amount allowad by low, will be added to all unpaid <br /> amounts outstanding. customer certifies that the individugl sighing <br /> this Service Acknowledgement is duly authgrixed to sign and bind <br /> custelper. Customer acknowledges that it is rospon,%ible for maintaining <br /> its Gonnrator Status and obtaining aH EPA 7:0 numbar if required by <br /> applicable Taw. The following prevision is applicable to <br /> Safaty-Rlten's parts clg4nar and paint gun cleaner sarviresl Customer <br /> agrgas that it will not inte4d4ee any substance into the solvent or <br /> aqueous cleaning solution, including without limitation any hazardoos <br /> waste or hazardous waste constituent, d*cept to the'txtent such <br /> Introduction is incidental to the normal use of the machine. Customer <br /> further agrees that it will not clean parka/paint guns that have been <br /> contaminated with or otherwise introduSg polychloriheted biphenyl■ <br /> 0"'0, herbicides, pesticides, dioxins or listed hazardous waste <br /> Into the solvent ar aqueous cleaning solutiaH. Safety-Uleen has the <br /> capacity and is permitted to accept, store, and/or reclaim the spent <br /> parts washer solvent; paint thinners, solvents and paint% ganarated by <br /> cust"PI er dry cleaning Filter cartridges, powder, and still <br /> residues containing porch1064thylene, pattolnum naphtha, or <br /> trifluratrichioroethana dry claan,ng solvents. Custoawr agrooa: that it <br /> is responsible For properly classifying its waste stramins as used 041 <br /> or Nonhszordous Waste in accordance with the provision of 40 CFR <br /> - .. .. -. _. a--•- ^• --- ------ .. -.1 __. <br />