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CSG SK- SSL-BOX-23 Raymond Gomez 02 / 07 / 17 10 : 21 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 /> REFERENCE NBR . <br /> CUSTOMER# ST37222 Stockton Sailing Club 72828261 <br /> 4980 Buckley Cove Way SRVC WEEK : 2017 - 6 <br /> Stockton CA 95219 - 2025 SRVC DATE : 02 / 07 / 17 10 : 21 <br /> PHONE 999 - 999 - 9999 <br /> BILL TO CUSTOMER# BILL TO ADDRESS : <br /> SA32681 County of San Joaquin DPW/ Solid Waste <br /> 1810 E Hazelton Ave <br /> Stockton CA 95205 - 6232 <br /> PHONE 909 - 947 - 9363 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE / TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 8003369 DRUM , 55 GL BLACK STEEL O 2 . 000 80 . 1800 14 . 03 174 . 39 <br /> SERVICE TERM 24 WEEK <br /> 733637 / <br /> 875460 CNO-NON HAZARDOUS SOLID 5 2 . 000 249 . 9600 0 . 00 499 . 92 <br /> SERVICE TERM 24 WEEK <br /> # CONTS : 2 TSDF : SJ MANIFEST # : 005863476SKS FORM CD : US SHIP# 221566887 <br /> CNT# : 170203999632 QTY : 150 WT /VOL P PROF# 733637 SKDOT 7430517 <br /> CNT # : 170203999633 QTY : 150 WT /VOL P PROF# 733637 SKDOT 7430517 <br /> 7207 MAT , SINGLE WGT OIL 16 " X 1 . 000 82 . 7700 7 . 24 90 . 01 <br /> 100001 FEE , FUEL SURCHARGE 1 . 000 10 . 8300 0 . 95 11 . 78 <br /> - -- -- - - - - - - - -- - - -- -- - -- - - -- - - - - -- -- - -- -- - <br /> TOTAL SERVICE / PRODUCTS 423 . 7400 22 . 22 776 . 10 <br /> TOTAL CHARGE 776 . 10 <br /> CREDITS 0 . 00 <br /> . .. . . . . . . . <br /> TOTAL DUE 776 . 10 <br /> --------------- <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT 776 . 10 <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 />