COMPLIANCE INFO_2018 - Laserfiche WebLink

Home Browse Search

CSG SK-SSL-BOX-23 Raymond Gomez 08/02/17 10:33 PAGE 1 Safety-Kleen Systems , Inc . 2600 N Central Espy, Suite 200 Richardson, TX 75080 CORPORATE: 800-669-5740 24 MR EMERGENCY; 800-468-1760 (Safety-Kleern) 2095451011 REFERENCE NBR. CUSTOMER# CA37093 Cal-'rrans Shop 10- Lodi 74350685-1703768391 845 E Pine St SRVC WEEK: 2017-31 Lodi CA 95240-3108 SRVC DATE: 08/02/17 PHONE 209-333-6953 BILL 10 CUSTOMER# BILL TO ADDRESS: CA39570 CAL Trans - Dist 10 Po Box 1632 Stockton CA 95201-3038 PHONE 209-948-7815 PURCHASE ORDER# TAX EXEMPT# PRODUCT/SERVICES SERVICE/ TOTAL PRODUCT QTY UNIT PRICE TAX CHARGE 26730 MODEL 26 W/STAND 6365 1.000 $0.0000 3.88 53.88 S/N 11013427 TAG 00001112SKIIQ13427 C'LEM 0.250 SPENT 0.000 SERVICE TERM 12 WEEK SCANNED YES # CONTS: 1 TSDF: SCA MANIFEST#: 006236821SKS FORM CU: US SHIP# 223011553 CNT#: 170726541025 QrY: 5 WT/VOL G PROF# 156013 SKOOT 14626 ' 94837 MODEL 94 W/2387 & 6365 1.000 88.0000 6.82 94.82 S/N 94120160 TAG T000OOUOXX9OnO003 CLEAN 2.000 SPEN"f 0.000 SERVICE TERM 12 WEEK SCANNED YES # CONTS: 1 TSOF: SCA MANIFEST#: 0061368ZISKS FORM CD: US SHIP# 22301ISS3 CNT#: 170726541026 QTY: 20 WT/VOL G PROF# 156023 SKDOT 14941 ------------------------ TOTAL SERVICE/PROOUC FS 138.0000 10.70 148.70 TOTAL CHARGE 148.70 CREDITS 0.00 --------------- TOTAL UUE 148.70 UNPAID BALANCE THIS RECEIPT 148.70 Machine clean and good condition? Yes Lanp Assembly Condition Yes Decals in Place and legible? Yes Fusible link installed? Yes Emergency closing of lid unobstructed? Yes Machine properly grounded? Yes Local Phone No. Sticker Affixed to Machine Yes Spent solvent meets acceptance criteria? Yes GENERATOR STATUS 220-2200 lbs/month Customer certifies that (i) the above-naceA ioate,ials are properly classified, packaged, marked and labeled, and are Jr. proper condition for transpurtation according to the applicable regulations of the Department of Transportation (ii) no material change has occurred either in tine characteristics of the waste/material o• in the process generating the waste/material, and (iii) the above referenced Generator Status iscorrect. Customer agrees to pay the above charges and to be bound by Che terms and conditions (1) set forth in (a) the General Terms and Conditions provided separately to Customer or (b) any SK agreement signed by Customer and SKand (2) iucw•porateA herein by reference. Unless otherwise indicated in the payment received section, SK is authorized to charge Customer's account for this transaction. If Customer, fails to make payment when due, an anoo,t equal to the lesser of (i) 1.596 per month (18% Per ammor) at- (10 r(i5) the nnaximuor annum allowed by law, will be added to All unpaid anoo,ts .utstandino. Customer certifies tbatthe individual signing this Service Acknowledgement is duly authorized to sign and bind Customer. Customer acknowledges that it is responsible for maintaining its Generator Status and obtaining An EPA ID ntsnber if required by applicable law. The followinU provision is applicable to Safety-Kleen's Parts cleaner and paint gun cleaner services: Customer agrees that it will not introduce any substance into the solvent or aqueous cleaning solu Hon, including without limitation Any hazardous waste or hazardous waste constituent, except to the extent such introduction is dncidmrtal to the normal use of the machine. Customer further agrees that it will not dean Parts/paint guns that have been co,taninated with o• aberwise introduce Polychlorinated biphenyls 01CR's), herbicides, Pesticides, dioxins or listed hazardous waste into the solvent or aqueous cleaning solution. Safety-Klee, has the capacity and is permitted to accept, store, and/or reclaim the spent parts washer solvent; paint thinners, solvents and paints generated by customer; or dry cleaning filter cartridges, powder, and still residues containing perchloroe thylene, petroleum naphtha, or triflurvtvichl.roe thane dry cleaning solvents. C..t.rAr agrees that it is responsible fur Properly classifyinU its waste streams as Used Oil or Nonhazardous Waste in accordance with the provision of 40 CFR 262.11 and applicable state laws. Custonner agrees that it will not introduce any non-conforming substance int. lire SK Property, - includinU, wi than lino ilatiun, any Lezerdous waste or I......Jon, waste c.nstituenq(i.e., polychl urinated biphenyls ("PCBs"), herbicides, Pesticides, dioxins, n• listed hazardous wastes) except to the extent