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CS1 <br /> CSG SK-SSL-UMO-Ol 30seph R Lima Ir <br /> - 03/25j18 13:15 PAGE 1 <br /> CU <br /> Safety-Keen Systems, Inc, <br /> 2600 N Central Ex <br /> py, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE. 860-669-5740 <br /> Gf 24 HR EMERGENCY: %00-468-1760 (Safety-Kleen) <br /> W 2095451011 <br /> TF CUSTOMER# SA32680 San ]aaquiu Co Maintenance REFERENCE NBR. <br /> ISIO E Hazelton Ave 76435248-1801495644 <br /> Stockton CA 95ZOS-6232 SRVC WEEK. 2018-13 <br /> PHONE 209-468-3099 SRVC DATE: 03j26J18 <br /> TF SILL TO CUSTOMER# BXLL TO ADDRESS: <br /> U, SA3268b San loaquin Co Maintenance <br /> 1810 E Hazelton Ave <br /> 'NI Stockton CA 95205-6232 <br /> {� PURCHASE ORDER# 3-26-IS PHONE 209-468-3099 <br /> FI TAX EXEMPT# <br /> T SERVICE/ PRODUCT/SERVICES <br /> PRODUCT TOTAL <br /> 66636 U 2 0.0000 CHARG <br /> 75.000 <br /> SED OIL RECYCLE AUTOMOTI 7Y UNIT PRIT 0.00 E <br /> 0 SERVICE TERM 8 WEEK 2 0.00 <br /> HALOGEN /CLOR-D-TELT TEST RESULT PASS. PPM c 1040 <br /> 10256 FEE, OIL SERVICE/STOP NON <br /> SERVICE TERM 8 S9£EK 1.000 182.5000 0.00 182,50 <br /> F ---------- <br /> TOTAL SERviCE/PRooUcfs ----------- <br /> F 182.5000 ---y 0,00----182.50 <br /> TOTAL CHARGE 182.50 <br /> CREDITS 0.00 <br /> i <br /> --------------- <br /> TOTAL DUE 182.50 <br /> UNPAID BALANCE THIS RECEIPT <br /> 182.50 <br /> Xf high risk source, rep. certifies that load specific pCB g,Silicon <br /> testing have been completed prior to Pumping this load. <br /> GENERATOR STATUS <br /> CESQG: Vehicle <br /> Customer certifies that Ci) 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 <br /> either in the characteristics(") no material change has occurred _ <br /> of the waste/material or in the process <br /> waste <br /> generating the /material, and (iii) the above referenced <br /> GeneratorStatus ti <br /> and to he bouns correct. Customer agrees to pay the above charges <br /> d by rhe terms and conditions (1) sforth in (a) the <br /> � y Customer or (b) <br /> et <br /> General Terms and Conditions provided separatelet Y 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 /> amount equal to the lesser of (i) 1.5% per month (18% Per annum) or <br /> :s <br /> (ii) the maximum amount allowed by law, will he added to all unpaid <br /> a.^rutaL:staadia0_ Customer certifies that the individual SltlhtiR6 <br />