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CSG S$-SSL-UMO-03 Joseph R Lima Jr 07/16/18 09:45 PAGE 1 <br /> Safety-Kleen Systems , Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE; 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Klean) <br /> 20SS451011 <br /> CUSTQMER# SA32684 San Joaquin Co Maintenance REFERENCE NBR. <br /> 1810 E Hazelton Ave 77394203-1803549826 <br /> Stockton CA 95205-6232 SRVC WEEK:' 201$-29 <br /> SRVC GATE; 07/i6118 <br /> PHONE 2 <br /> HILL To CUSTOMER# BILL TO ADDRESS99-468-3099 <br /> SA32680 San Joaquin Co Maintenance <br /> 1810 E Hazelton Ave <br /> Stockton CA 9S205-6232 <br /> PURCHASE ORDER# 7-16-18 PHONE 209-468-3099 <br /> PRODUCT/SERVICES TAx EXEMPT# <br /> SERVICE/ <br /> PRODUCT TOTAL ' <br /> 66636USED OIL RECYCLE AUTDMOTI 270.000 PRICE TAX <br /> T 0.00 CHARGE <br /> SERVICE TERM 8 WEEK <br /> HALOGEN /CLOR-D-TELT TEST RESULT PASS: AAM < 1000 <br /> 10256 FEE, OIL SERVICE/STOP NON 1.000 102.5000 0.00 182.50 <br /> SERVICE TERM 8 WEEK <br /> ---- --- --- -^....- <br /> TOTAL SERVICE/PRODUCTS 182.5004 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 load specific PCB & Silicon <br /> testing have been completed prior to pumping this load. <br /> GENERATOR STATUS <br /> CESQG: Vehicle <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 <br /> generating the waste/material, waste/material or in the process <br /> and Ci ii) 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 /> r'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 /> amount equal to the lesser of (i) 1.536 per month (18%per annum) or <br /> (ii) the maximum amount 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. Custamer acknowledges That it is responsible for maintaining <br /> its Generator Status and obtaini:g an EPA ID number if required by <br /> applicable law. The following provision is applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br /> agrees t4iat it will Biot:introdiuc. any substance int- the soivene o <br /> aqueous cleaning solution, including without limitation any hazardous <br /> waste or hazardous 'waste constituent, except to the extent such <br /> :nr.rod r ti:. is ircid•_-Ztal to the normal use oT tfee wachi^c. CL tomer <br />