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CSG SK-SSL-UMO-01 Joseph R Lima Jr 01/10/18 08:33 PAGE I <br /> Safety-661 een 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; SA3268D San Joaquin Co Maintenance REFERENCE NBR. <br /> 1810 E Hazelton Ave 7587.8104-1800142206 <br /> Stockton CA 95205-6232 SRSRVC WEEK: 201$-2 <br /> VC GATE: 01/10/1$ <br /> PHONE BILL TO CUSTDMER9 BILL TO ADDRE55�6-941-2910 <br /> SA32680 San Joaquin Co Maintenance <br /> 1810 E Ha2elton Ave <br /> Stockton CA 95205-6232 <br /> PHONE 916-941-2910 <br /> PURCHASE ORDER# 251561 TAX EXEMPT,', " <br /> SERVICE/ PRODUCT/SERVICES <br /> PRODUCT 2 TOTAL <br /> 66636 USED UTL RECYCLE AUTOMOTI 0.00D P�0.0000 TAX0 000HARGE0.00 <br /> SERVICE TERM 8 WEEK <br /> HALOGEN / CLDR-D-TECT TEST RtSULT PASS: PPM [ 1000 <br /> 10256 FEE, OIL SERVICE/STOP NON 1.000 182.5000 0.00 182.50 <br /> SERVICE TERM 8 WEEK <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 182.5000 0.00 182.50 <br /> TOTAL CHARGE 182,50 <br /> CREDITS 0.00 <br /> ------------- <br /> TOTAL DUE 182.50 <br /> UNPAID BALANCE THIS RECEIPT 182.50 <br /> If high risk source, rep. certifies that Toad specific PCB & Silicon <br /> testing have been completed prior to pumping this load. <br /> GENERATDR STATUS <br /> CESRG: Vehicle <br /> I <br /> Customer certifies that (i) the above-named materials are properly <br /> classified, packaged, marked and Tabeled, 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 wastelmaterial, 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 /> .mount equal to the lesser of (i) 1.5% per month (18% per annum) or <br /> (ii) the maximum amuunt allowed by larr, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the individual signing <br /> this Service Acknowledaement is duly authorized to &inn ana hlna <br />