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DUPLICATE TICKET <br /> CSG SK -SS -01 Joseph R Lima Jr 12/09/19 (s PAGE 1 <br /> SJC LOVELACE MRF /TRANSFER STAT <br /> 2323 E . LOVELACE RD . Safety - K1 een Systems , Inc . <br /> MANTECA , CA . ( 209 ) 982-5770 2600 N Central Expy , suite zoo <br /> MON4RI 7 -4 SAT-SUN 7-4 _ Richardson , TX 75080 <br /> CORPORATE : 800 -669 -5740 <br /> 24 HR EMERGENCY : 800 - 468 -1760 (Safety- Kleen) <br /> 2095451011 <br /> Weighed : LIDIA B . <br /> CUSTOMER# L024138 Lovelace Material Recycling Center 81688705E1 06171RENCE 191 <br /> Uaposlt4 SABRINA 2323 Lovelace Rd SRVC WEEK : 2019 -SO <br /> BILL TO : 0 Manteca CA 95336 -9233 SRVC DATE : 12/09/19 <br /> PHONE 209 -610 - 2001 <br /> BILL TO CUSTOMER# BILL TO ADDRESS : <br /> L024138 Lovelace Material Recycling Center <br /> 2323 Lovelace Rd <br /> Manteca CA 95336 - 9233 <br /> PURCHASE ORDER# 54947 PHONE 209 -610- 2001 <br /> Vehicle ID : W PRODUCT/SERVICES TAX EXEMPT# <br /> Reference : 9F02816 SERVICE/ <br /> PHONE : FC 110 GAL PRODUCT QTY UNIT PRICE TAX CHARGEOTAL <br /> 66665 ANTIFREEZE (NON-PREQUAL) 1 . 000 0 . 0000 0 . 00 0 . 00 <br /> : SALVAGE SERVICE TERM 8 WEEK <br /> Origin <br /> DATE SALVAGE CAUSE <br /> TIME IN : 0 / : 37 : 37 CAUSE CODE VOIDHEADERANDLINE -SERVICE NOT NEEDED <br /> DATE OUT : 12/09/2019 TIME 01114 08 : 58' : 55 10256 FEE , OIL SERVICE/STOP NON 1 . 000 120 . 0000 0 . 00 120 . 00 <br /> SERVICE TERM 24 WEEK <br /> 66636 USED OIL RECYCLE AUTOMOTI 865 . 000 0 . 0000 0400 0200 <br /> OUTBOUND TICKET Number : 51 - 01062489 SERVICE TERM 4 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS : PPM < lODO <br /> SCALE 3 GROSS WT . 30500 LB TOTAL SERVICE/PRODUCTS 120 . 0000 0 . 00 120 . 00 <br /> SCALE 2 TARE WT . 24100 LB TOTAL CHARGE 120 . 00 <br /> NET WEIGHT- 6400 LB CREDITS 0000 <br /> TOTAL DUE - - - - -120 . O0 - - <br /> X # REPRINTED BY UNPAID BALANCE THIS RECEIPT 120 . 00 <br /> LIDIA at 08 : 59 : 59 <br /> Qty Description Amount <br /> 3 . 20 OIL SALVAGE 0 . 00 If high risk source , rep . certifies that load specific PCB & Silicon <br /> testing have been completed prior to pumping this load . <br /> TICKET AMOUNT : 0 . 00 <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 waste/material or in the process <br /> X generating the waste/material , 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`Cu5tomer or (b) <br /> any SK agreement signed by Customer and SK , and (2) incorporated <br /> _'.,_ ,. _ <br />