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Received on 12/09/2019 <br /> EHD - CR <br /> CSG 9E-99L-IMO-01 Joseph R Lima Jr 10/04/19 08:25 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> R,chardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 ER EMERGENCY: 800-468-1760 (Safety-Eleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMER# .17048 Abate Far— 81285975-1905292209 <br /> 14300 5 Robert. Rd SRVC WEEK: 2019-41 <br /> Stockton CA 95206-0000 SRVC DATE: 10/04/19 <br /> PHONE 209-483-2533 <br /> BILL TO COSTOMERA BILL TO ADDRESS: <br /> ST37094 Stockton Petroleum <br /> 1905 Navy In <br /> Stockton CA 95206-1141 <br /> PHONE 407 428 3073 <br /> PERCHARE ORDERA lox, tor—ll TAX EXE.T{ <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PAODOCT QTY OBIT PRICE TAX CHARGE <br /> 66636 USED OIL RECYCLE AUTOBOTI 525.000 0.1200 0.00 63.00 <br /> SERVICE TERM 12 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPR G 1000 <br /> 10256 FEE, OIL SERVICE/STOP NON 1.000 175.4500 0.00 175.45 <br /> SERVICE TERM 12 WEEK <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 175.5700 0.00 238.45 <br /> TOTAL CHARGE 238.45 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 238.45 <br /> UNPAID BALANCE THIS RECEIPT 238.45 <br /> Ifhigh x,ek source, <br /> rep, cert,£,.. that load ep...fie PCH s S,l...n <br /> to,t,ng Mve be ncoWl.t.d prior to pumping this load. <br /> GENERATOR STATUS <br /> CESQG: Vehicle <br /> Customer certifies that (1) 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 ofTransportation („) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material, and (,,,) the above referenced <br /> Generator Status i9correct. Customer agrees to pay the above charges <br /> and to be bound by the terms and cond,t— (1) at 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 fail, to make payment wMn due, a <br /> adcunt equal to the lesser of (1) 1.58 per month (188 per annum) o <br /> („) the max,— —unt 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 acknowledge. that it i9responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law. The follow,ng provision , applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br />