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CSG SH - BWP - LINO - 03 Yang , Richard 03 - 18 - 2021 16 : 17 PAGE 1 V- 5 . 2
<br /> Safety- Kleen Systems , Inc .
<br /> 42 Longwatei: Drive
<br /> Harwell , VA 02061
<br /> CORPORATE : 800 - 669- 5740
<br /> 24 HR EMERGENCY : 800 - 968 - 17C- 0 ( Safety - B _ een )
<br /> 2095451011
<br /> REFERENCE NBR ,
<br /> CCSTOMER4 TI23397 Certified Tire 1649 85516062 - 2100902964
<br /> 1131 Holly Dr SRVC WEEK : 2021 - 12
<br /> Tracy SRVC DATE : 03 - 18 - 2021
<br /> PHONS. 209 - 83 " - rJ1DD
<br /> BILL TO CUSTOMER # BILL TO ADDRESS :
<br /> M02S5b5 Monro Muffler Brake
<br /> 200 Holleder Pkwy
<br /> Attn : Accts Payable
<br /> Rr, chester
<br /> IIY 14615 - 3808
<br /> PHONE 262 - 542 - 1888
<br /> PURCHASE ORDER # 2111 TAX EXEMPTk
<br /> PRODUCT/SERVICES
<br /> SERVIrE / PRODUCT QTY UNIT PRICE TAX TOTAL CHARGE
<br /> 66636 USED OIL RECYCLE AUTOMOTIVE OIL 175 . 0 CP CP CP
<br /> HALOGEN / CLOR-D-TELT TEST : PASS ; PPM < 1000
<br /> TOTAL .SERVICE / PRODUCTS _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ - _ _ _ -
<br /> CP CP CP
<br /> TOTAL CHARGE CP
<br /> CREDITS CP
<br /> - - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
<br /> TOTAL DUE CP
<br /> UNPAID BALANCE THIS RECEIPT CP
<br /> If high risk source , rep . certifies that load spec. i _ ic. PCB & Silicon
<br /> ear inq have been complered prior c purnp _ ng this load .
<br /> GENERATOR STATUS
<br /> 'EIdQ�� ; / eh ule
<br /> _a .stomer certifies that ( i ) the I have established a program to reduce the volume above - named materials are properly or
<br /> quantity and Toxicity of the hazardous waste classified , packaged , marked and to the degree to be economically
<br /> practicable , labeled , and are in proper condition for transportation according to the applicable regulations of the
<br /> Departrnenr of Transporratiou ( ii ) no material change has occurred either in the characteristics of the waste /material or
<br /> in the process generating the waste / material , and ( iii ) the above referenced Generator Status is correct . Customer agrees
<br /> to pay the above charges and to be bound by the terms and conditions ( 1 ) set forth in ( a ) the General Terms and
<br /> Conditions provided separately to Customer or Ib ) any SK agreement signed by Customer and SK , and ( 2 ) incorporated herein
<br /> by reference . Unless otherwise indicated in the payment received section , SK is authorized to charge Customers account
<br /> for this transaction . If Customer fails to crake payment when due , an amount equal to the lesser of ( i ) 1 , 5a per month
<br /> ( 18 , per annum ) or ( ii ) the maximum amount allowed by law , will be added to all unpaid amounts outstanding . Customer
<br /> certifies that the individual signing this Service Acknowledgement is duly authorized to sign and bind Customer . Customer
<br /> acknowlecipes that it is responsible for maintaining its Generator Status and obtaining an EPA ID number if required by
<br /> applicable law . The following provision is applicable to Safety-Kleens parts cleaner and paint gun cleaner services :
<br /> Customer agrees that it willnot introduce anv substanr_e into the solvent or aqueous cleaning solu _ icn , including without
<br /> : imitation any hazardo .is :caste or hazardous Waste constituent , except to the extent such introduction is incidental to
<br /> the normal use of the machine . Customer further agrees that it will not clean parts / paint guns that have been
<br /> contaminated with or otherwise introduce polychlorinated biphenyls ( PCBs ) , herbicides , pesticides , dioxins or listed
<br /> hazardous taste o intthe solvent or aqueous e'_ eaning solurion . Safety -Kleen has the capacity and is permitted to accept ,
<br /> :, tore , and /or reclaim the spent parts washer so - vent ; paint thinners , solvents- and paints generated by customer ; or dry
<br /> tteaning filter cartridges , powder , and still residues containing Perch to roe thylene , petroleum naphtha , or
<br /> trifL� rotrichloroethane dry cleaning solvents . Customer agrees thatit is responsible for proper ' y c : ossifying its waste
<br /> streams as Used Oil or Nonhazardous Waste in accordance with the provision of 40 CCR 262 . 11 and applicable state laws ,
<br /> 1l _ _ . T _ .. agrees that it will not introduce any non - conforming substance into the SK Property , including , without
<br /> mitetion , any hazardous waste or hazardous waste constituent , ( i . e . , polychlorinated biphenvls ( " PCBs " ) , herbicides ,
<br /> � . � .. i 1 , s , t, c . _ o t :- t_i ha 2a LjJUS +. o .. cool sXceps L (- LL = ex cent such in t rodeo tion rs inc _ den : a _ to the normal use
<br /> 16 P11prrty . In the ev - rit of the inti educt ion � f Gush on conforming hazardous waste , Custrar.er agrees that it will
<br /> be responsible for all costs and re .mediat _ on expenses related to or arising from the proper management and disposal of
<br /> rhe - ion - oonforming waste , n
<br /> +_ cicding the -1ost of equipment decontamination and subsequent disposal . Final invoicing will
<br /> be based or, the actual services provided , which may include additional charges for off specification waste and
<br /> ince GL a1 jIjof i e eg r sp t ter . than of amount listed se theonprinted r ome If xnygr [ he � �
<br /> o: m nrel bet ica of an alleged dispute , bre ch default or :i re resents tion , theCustomer also a r t he
<br /> ) r , .: 11 I ( , ai _ 1 , he E t _ lc -. , i cover _ eoQonahle a (' Ile , u fees and cosh s ., so .; _ ated with the To r
<br /> ED
<br /> wntamination event . Safety- Kleens failure to screen Customers material or cake a retain sample , in no way constitutes a
<br /> veiver of Custorners obligation to properly classify its materials . Safety- Kleen relies On Customers representations and
<br /> Costaner is responsible for informing Safety- Kleen of any process changes that may alter the characteristic pf th�
<br /> 2022
<br /> ENVIRONMENTAL HEALTH
<br /> DEPARTMENT
<br />
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