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CSG SK-SSL-OOX-23 nap"" Gomez 00/14/19 13:50 PAGE 1 <br />Safety-Kleen Systems, Inc. <br />2400 N Central Expy, Suite 200 <br />Richardson, TX 75080 <br />CORPORATE: 900-659-5740 <br />24 HR EINERGENCY: 600-448-1760 (Safety-Kleem) <br />2095451011 <br />REFERENCE W. <br />CUSTOMER# AM23877 Amberland Composites 81156406 <br />3632 Duck Creek Or SMK WEEK: 2019-38 <br />Atta. Sowphou SM DATE: 09/16/19 <br />Stockton CA 95215-7440 <br />PHONE 200-460-1600 <br />RILL 70 CUSTOMER# RILL TO AD0RESS: <br />/M23877 Amberland Composites <br />3632 Duck Creek Or <br />Attu. Somphou <br />Stockton CA 95215-7940 <br />RHONE 209-460-16-10 <br />P R CIIMR ONDER# TAX EXE PT# <br />PRODUCT/SERVICES <br />SHWICE/ <br />TOTAL <br />PRODUCT QTY UNIT PRICK? <br />TAX CHARGE <br />135/610/ <br />875000 H$1-LQD FOR FUEL SSGL 1.000 246.3600 <br />0.00 246.36 <br />SEMMCE TEAM 24 WEEK <br />0 COMM 1 TSDF: UUP MANIFESTS: 007159168SKS F0RM CD: US SM1P# 229506900 <br />CNTB: 160010094935 QTY: 150 WF/MDL P PROF# 135010 <br />SKDDT 7914410 <br />100030 RECOVIRY FEE 1.000 19.7100 <br />0.00 10.71 <br />100063 E -Manifest Fee 1.000 10.0000 <br />0.00 10.00 <br />----------------------------------------- <br />70TAL SERVICE/PRODUCTS 276.0700 <br />0.00 276.07 <br />70TAL CHARGE 276.07 <br />MOM 0.00 <br />--------------- <br />70TAL DUE 276.07 <br />UNPAID RALMHCE THIS RECE3PT 276.07 <br />G2101RATOR STATUS <br />0-220 lbs/manth <br />Custmar certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />far 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/ieaterial or in the process <br />generating the wasta/material, and (iii) the above referenced <br />Generator States is correct. Customer agrees to pay the above charges <br />and to be bound by the terms and condition C1) set forth is W the <br />General Terns and Conditions provided separately to Cwstamer or pi) <br />nay SK aoreesaat signed by Customer and SK. and a) incorporated <br />borein by reference. Unless otherwise indicatd in the payaeat <br />received section, S6 is authorial to charge Customer's acceant for <br />this transaction. If customer fails to make paVemet when doe, an <br />assent equal to the lesser of (1) 1.SR per month (in per num* or <br />(ii) the maximum amount allowed by law, will be added to all agaid <br />neonate eatstanding. Customer certifies that the individual signing <br />this Service Acknowldgemmit is duly authorized to sign and bird <br />Customer. CQstamer acknowledges that it is responsible for saiotaiming <br />its Generator Status and obtaining me EPA 10 weber if required by <br />applicalao law. The following prevision is applicable to <br />Safaty-Kleen's parr cleaner and pint gra cleaner services: Customer <br />agrees that it will not introduce nay substance into the solvent or <br />apaoas cleanin;'solutin. including without limitation any hazard" <br />waste or hezardous waste constituent, except to the extent such <br />introduction is incidental to the mensal we of the meehims. Customer <br />further agrees got it will met Clean parta/Paint`gguunnss that have been <br />eontminateA with or otherwise introduce polychlorivatd bipbesyls <br />00's), herbicides, pesticides, dioxins or listed hazardous` waste <br />. -•- -- .--- -- - ......I...<,.., ..1.. -- - - -- --- <br />