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SK-SSL-UMO-01 Benjarni:: 0 Taylor 12/06/18 12:34 PAGE 1 <br /> Safety-Keen Systems , Inc . <br /> Z600 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 /> STOMER# SA32680 Sao ]oaquin Co Maintenance 78463039-1805772372 <br /> 1810 E Hazelton Ave SRVC WEEK: 2018-49 <br /> Stockton CA 95205-6232 SRVC-DATE- 12/06/18 <br /> PHONE'209-468-3099 _ <br /> LL TO CUSTOMER# SILL TO ADDRESS: <br /> 3Z63O San Joaquin Co Maintenance <br /> 1810 E Hazelton Ave- <br /> Stockton CA 95205-6232 <br /> PHONE 209-468-3099 <br /> RCHASE ORDER# TAX EXEMPT* <br /> PRODUCT/SERVICES , <br /> ,LR110E/ TOTAL <br /> PRODUCT QTY. UNIT PRICE TAX CHARGE <br /> 636 USED OIL RECYCLE AUTOMOTI 111.000 0.0000 0.00 0.00 <br /> SERVICE TERM 8 WEEK <br /> HALDGEN J CLOR-D-TECT TEST RESULT PASS: PPM K 1000 <br /> 456 FEE, OIL SERVICEJSTOP NON 1.000 182.5000 0.00 182.50 <br /> SERVICE TERM 8 WEEK <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 182.5000 0100 182.50 <br /> TOTAL CHARGE 182.50 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL. DUE 182.50 <br /> UNPAID BALANCE THIS RECEIPT 1.82.50 <br /> high risk s,—,c.-, —p. certifies that load specific PCB &Silicon <br /> sting have been rampleted prior, to pumping this load. <br /> NERATOR STATUS <br /> SAG: Vehicle <br /> stomer certifies that (i) the above-named materials are properly <br /> fieri, packaged, marked and labeled, and are in proper condition <br /> z-•ansportatio, according to the applicable regulations of the <br /> .,.r:ment of :eansportation (ii) no materia` change has occurred <br /> ,che,- in the C'..dCte'istiCS of thrr waste/material or in the process <br /> :nesting the waste/mates a,, and (iii 'yre ;above nef,-,,enced <br /> ;,erator• Status is correct. CUStolnnr agr«s to pay the above r,. _ <br /> rd to be bound by the ter, and conditions (1) set forth :,, - <br /> m,erai Terms and Conditions pr-avid,I sepa tely to Customer nr is <br /> +'r SK agreement signed b Customer and SK, � d (2) incorporated <br /> rein by reference. UnlcI= orbcrwise indicated 'n the paymc <br /> ..,eived section. SK tis ,.0—,- —0 to harye CustuWar's accuwr.. 11- <br /> ,is <br /> ,.tis transaction. If Custower oke mens when due. an <br /> n.rant equal to the 'essr i non-: 01896 per, ,v: an) or <br /> i-1; the maximum amour- ..owed L - .711 s,. Added to <br /> nounts , *standing. i.--comer cert. res LinaL :he individua: yikii <br /> his Servir.- Acknmuledgement is duly authorized to sign ancr b:,, <br /> -mer acknowledges that it is responsible for maintaining <br /> .rr �ht0ininry an FPA TO number if required by <br /> - - vuli,,ming pruvi <br /> ;i 11 not intrad," or <br />