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CSG SK-55l-UMO-02 <br /> Mi"el Unsure- 04/27/16 08:13 PAGE 1 <br /> Safety-Kleen Systems , Inc . <br /> 2600 N Central E%PY, Suite 200. <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-S740 <br /> 24 HR EMERGENCY: 806-468 760 (Safety-Kleen) <br /> 209545101 <br /> REFERENCE NOR. <br /> 70186113 <br /> CUSTOMER# CA47950 Cal Tans Sh-P 10 Cws SMC WEEK: 2016-18 <br /> 2005 Krohn Rd SRVC DATE: 04/27/16 08:13 <br /> Tracy CA 95377-9120 <br /> PHONE 209-835-6779 <br /> DILL TO CUSTOMER# CUXLL a'traO ADDRESS: <br /> fA47760 Po Box 1632 <br /> Stockton PHONE5209-94887815 <br /> FAX E%EMPI"# <br /> PURCHASE UNDER# PRODUCT/SERVICES <br /> TOTAL <br /> SERVICE/ DIV UNIT PRICE TAX CHARGE <br /> PRODUCT <br /> 66636 USED OIL NON-PREOUAL SERV 18.000 <br /> SERVICE TERM 16 WEEK <br /> HALOGEN / CLOR-D-TECT IIS'"RESULT' PASS: PPM a 1000 <br /> 10256 EEE, USED OIL STOP CHARGE L6U0 <br /> SERVICE TERM 16 WEEK .-__.-...------ <br /> TOTAL SERVICE/PRODUCTS <br /> TOTAL CHARGE <br /> CREDITS <br /> _____________ <br /> TOTAL DUE <br /> UNPAID BALANCE THIS RECEIPT <br /> If .i01. risk 1-oI It, Fell. certifies that land specific PCB a Sili'-o <br /> Les ti" have Leen cmnpleted Prior to pump inB this load. <br /> GENERATOR STATUS <br /> C ESQG: Vehicle <br /> Customer certifies that (i) the Aha ve-owned woteri.is are Properly <br /> classified, yacAaOed, marked and labeled, and are in Proper condition <br /> far Iran slrm4 atkan d, main, to the applicable re9ulaliaos or the <br /> Department of Transpprtatimi (i i) no mater it, change has oill The r reA <br /> be <br /> .'ither in the characteristics ort (iii) Ll,e ab"r, <br /> re Fe renclel l°ocess <br /> Boller.,inU the waste/nmterial' to p.y the abvle chol:hes <br /> Generator Status i< correct. Costumer a9reez <br /> and to be bmuul by the terms and cadd it ions (1) set fort. in (.) <br /> General Tenor and ConAitions Vrovid eA sepuratarlly @) <br /> 20 iocorPor ted <br /> any S8 XUreeineot si9rred by Customer and SK, () 0 y,ne <br /> hn re in LY re Poreno5K is au tlrori-ed tothervAlla <br /> cbal•BeCOSTrane il.rd ill s ..count Pm <br /> received sec ti mi, <br /> this transaction. Tf Cnstmner Fu its to ,nuke payment ob ear la,11i1eJ ol. - <br /> wnuunt equal to the lesser of (i) 1 5% per month (18% p <br /> V('i) Ihp mariunm, wnonnt "love" by tan, will be added to .11 unpaid,._ <br /> al ler the characteristics of the materials Provided. IN THEEVeNT OF <br /> AN EMERGENCY CALL —24-HR NUMBER" 1-800-468-1760 (SafetyKleen) <br /> I .ave established a PrroOr.o Lo .oq..e the vo Lm,e .1 quantity and <br /> toxicity of the hazardous waste to the deOree to be economically <br /> Pratt icabie. <br /> sign,7lure <br /> CUSTOMER / GENERATOR: roy ederbne•0 <br /> Sllnature <br /> THMSPoRTER: Mi9ne1 Onsure- <br />