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CSG SK-SSL-BOX-23 Raymond Gomez 09/27/18 12:42 PAGE 1 <br /> Safety-Kleen Systems , Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> CUSTOMER# M032003 Morada FarmREFERENCE NOR. <br /> 78056532-1804957488 <br /> 500 N lack Tone Rd SRVC WEEK: 2018-40 <br /> Stockton CA 95215-9725 SRVC DATE: 09/27/18 <br /> PHONE 209-556-5000 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> ST37094 Stockton Petroleum <br /> 1905 Navy Or <br /> Stockton CA 95206-1141 <br /> PHONE 407-428-3073 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> PRODUCT <br /> COTOTAL <br /> PRQTY UNIT PRICE TAX CHARGE <br /> 83383 ORUM,55 WASTE O.F. 2.000 105.0000 0.00 210.00 <br /> SERVICE TERM 24 WEEK <br /> # CONTS: i TSOF: TPO MANIFEST#: 006777979sks FORM CD: US SHIP# 226598293 <br /> CNT#: 180927997544 QTY: 250 WT/VOL P PROF# 156033 SKDOT 7872676 <br /> 3383 DRUM,55 GAL FOR O.F. 3.000 23.5400 0.00 70.62 <br /> SERVICE TERM 24 WEEK <br /> 100030 RECOVERY FEE 1.000 25.2600 0.00 25.26 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 3.000 0.0000 0.00 0.00 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 153.8000 0.00 305.88 <br /> TOTAL CHARGE 305.88 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 305.88 <br /> UNPAID BALANCE THIS RECEIPT l�j CS $VED <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Customer certifies that (i) the above-named materials 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 (ii) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material, and (iii) the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to be bound by the terms and conditions (1) set forth in (a) the <br /> General Terms and Conditions provided separately to Customer or (b) <br /> any SK agreement signed by Customer and SK, and (2) incorporated <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section, SK is authorized to charge Customer's account for <br /> this transaction. If Customer fails to make payment when due, an <br /> amount equal to the lesser of (i) 1.5% per month (18% per annum) or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the individual signing <br /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer. Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law. The following provision is applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br /> agrees that it will not introduce any substance into the solvent or <br /> aqueous cleaning solution, including without limitation any hazardous <br /> waste or hazardous waste constituent, except to the extent such <br /> introduction is incidental to the normal use of the machine. Customer <br /> further agrees that it will not clean parts/paint guns that have been <br /> contaminated with or otherwise introduce polychlorinated biphenyls <br /> 03CR's), herbicides, pesticides, dioxins or listed hazardous waste <br /> into the solvent or aqueous cleaning solution. caf,.*.,_vle_., i.__ <br />