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CSL SK-SSL-BOX-23 lta tii'm nd Gomez
<br /> 02114/I7 10:53 PAGE t
<br /> Safety-Kleen Systems , Inc .
<br /> 2600 N Central Elpy, Suite 200
<br /> H ichardson, T% )5080
<br /> CORPORATE: 800-669-5740
<br /> 24 HR EMERGENCY: 800-468-1760 (Safely-Kleen)
<br /> 2095451011
<br /> LOS TUKIERU C"1958 Cal frail, Shoe 1U- lodi (x:z REFERENCE NRR.
<br /> 845 E Pine St 7(549845-1/00413[18
<br /> Lodi CA 95240-3108SFVC WEEK: 2017-5
<br /> RILL TO CUS TOntEH4 BILL 10 APHONE NDRESS 09 333-695] SRVC DATE: 02/14/17 10:53
<br /> CA47769 Caltrans Cres
<br /> P4 Roz 1632
<br /> ,tochtaR CA 95201-3038
<br /> PURCHASE ORDE134 PHONE 209-948-7815
<br /> SERVICE/ PRODUCT/SERVICES TAX EXEMPT.
<br /> '
<br /> PRODUCT TOTAL
<br /> 40713004/ QIY UNIT PRICE TAX CHARGE
<br /> 875460 (NO-NON HAZAR DUES SOLID 5 1.000
<br /> SERVICE TERM 12 WEEK IIV.0000 0-00 140.00
<br /> F CUNIS: 1 ISUF: 8L FAN1FtSIR: 00S66318/SKS hUHM LU:
<br /> LN fF: I/011583140/ QTY: IS0 US SH1Y4 ([tVS[91N
<br /> NINUL M PROF# 40/1M, SKEW /3/0310
<br /> 3383 DRU41,55 GAL FOR O,F. 1.009
<br /> SERVICE TERM 32 WEEK - 0.0000 0.00 0.00
<br /> 8338) URU9,55 WASTE O.F. 1,000
<br /> SERVICE TERM 12 BEEN 45.0000 U.00 4S DO
<br /> N LON fly: I ISUE; IPA MANIFbll; VO1/1,0860SKS lOHN " US D,Y, GZI30480,
<br /> CNf4; 170107486125 QTY: [00 %F/VOL P PROF# 156133
<br /> 8003369 DRUM, 55 GL BLACK STEEL V 1,000 SKDUI /8/ffi/h
<br /> SERVICE TERM 12 WEEK 010000 0.00 0.00
<br /> 100001 FEE, FUEL SURCHARGE
<br /> 3230 TAX HANDLING N/C DRUM .'ROP f0 d1. 0 0.0000 0,00 0.00
<br /> 0pp O.DaDQ 0.00 1.00
<br /> POTAL Stl2VICf/PRODUCTS - -__-.- ---'-
<br /> Ias.ppp0 0.00 I85.00
<br /> TOTAL CHARGE 185,00
<br /> CREDITS 0.00
<br /> TOTAL DUE 185,00
<br /> UNFAIR BALANCE THIS RECEIPT 385,00
<br /> GENERATOR STATUS
<br /> 220-2200 lbz/month
<br /> Cmtoner certifiu tlwt (i) L,l nbuv - m r-inh
<br /> cla>sified, yacka0,d, nark ell anJ lnbeleluerind a a e Peel ei,,olrvJ i tion
<br /> For trar....L, Hon auurJ iu9 to the allyl icnble , c
<br /> Oeparel�ent of ri.awns roi tact ion In a reUn lat ioriz Ifthy,Cn) tial I V ku oIur ed
<br /> eitl er t tl chore t t3 f tl t ,Tal 1
<br /> B,nerai3 9 tl st (- L I l a 1 (r I I) Ll, ab n L,d yr occas
<br /> Ler eras Stac r> i> t C zt - f re ted
<br /> and to b u d by tter sof, Jarye>
<br /> G,Ile ral Te rr,> and CIII"iti `s OrJ Uuns (p et for tlr n (a) the
<br /> p rovlded cepa ra Lely to Clstoluel' 01 (b)
<br /> any S'I a9re eluent siun ml by Cra[oand Sk, and (2) incorporated
<br /> here rlr by reference. Unless othere.Tse illd ica teA iu the Papnent
<br /> rete veA section, SR is mtLurimJ to Lh., y Gu[Diner's a count (ur
<br /> this tl'arls ac Hon. If Customer fails to maFe Payment "Hill, due, a
<br /> un[ equal to till lesser of (i) 1.5R, yer nm9th (18% ycr' a Inn? 0
<br /> Cii) the nla,{,unm wluunt allm.,d b, la,., v.ill be added to all unPa id
<br /> w u[z u[stanJ iu4, Curtw rtif ie> LIIa[ the lull ie iduel
<br /> nuu o fier ce
<br /> �
<br /> [
<br /> [s Gene ra Lor tS to Lu+ and aL tla in iu,as LL Qe+I,a by ib le fur „ain La iu in0
<br /> applicable laa,. The Folll,,inr 3 n FPA LU n il,L er IF rvyuired by
<br /> Sefe[y-1:7 een,9 I Proais ion i> aypl icaLle to
<br /> yill clean m- mol Paint gun cleave l' Cmtu..,er
<br /> a9fee> [!la[ it I.ill nut Introdoe, any Iuloelh, >ul rent u
<br /> ayueom clean in0 +Vintimi, iucluJ i119 u.i11.oAI lis,i to L jun auy 1..,y,dum
<br /> I.as to ur' hazardo u> .az to c atituenl, e ,,Pt Lu LL, ertult such
<br /> In[rodue[ion
<br /> is iuc iJmrtal utU the alVf till
<br /> ELI ay ree> that It I;ill
<br /> u[ cle Lill �imdlire Cus tlr.„er
<br /> ntw r
<br /> ted uiLh aUr VLhe it a'ts/Ire nt 9wu that IIa a Le n
<br /> w I ' in t,U Ju-e yV1yJllorina
<br /> I' teJ bildlwls ,
<br /> CB's), herbicides, PestiC'Ill Jior Tru or listeJ yhezafllu us �.,Aste
<br /> intU tlr, solvent or aglama nlearlirm sulntifirl. SaFety-Kle,n has the
<br /> Ls,' t1 I t 1 itt I L cel t -[
<br /> 1 t s. I 1 (e t tI 'n °I 1-t till >PCVI.
<br /> 1 I. 4 f 1[ tr 12 r I till
<br /> -IIIJ 11y,1111I,rtl,ll,.l 1 t ' 1.r
<br /> t'I FI vl 11 - elha I
<br /> rt a les tit
<br /> IV Ibl f IIr 1 ly 1 Fy 3 i I l .z U> .] 0 eJ 011
<br /> 262Nllla I aPllr ble L t In s cel r 40 CFR
<br /> n LrVJuce mIY nun- ooful ' thew lllel rt ..ill nut
<br /> m boli n13 obs[once
<br /> r19, itimut 1 iii itntiV rl� mq Lam nbu+LII. SR PrVper ly,
<br /> S PIstituxn l,(i.e., yol .Irl ulil Lem nlVm ...0 to
<br /> V+lit iJe>, diu,in. „Y t;,,..., Ied Lllrh elry l; (uPCB.'�3, Le rL it iJra.
<br />
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