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CSG SK-SSL-BOX-21 Valdez,Leonard 03-11-2022 11:00 PAGE 1 V-6.4 <br /> Safety-Kleen Systems, Inc. <br /> 42 Longwater Drive <br /> Norwell, MA 02061 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NEE. <br /> CUSTOMER# OR12256 O'Reilly # 3811 88488962 - 2107720721 <br /> 1950 McHenry Ave SRVC WEEK: 2022-10 <br /> Escalon SRVC DATE: 03-11-2022 <br /> CA 95320-2081 <br /> PHONE 209-838-6384 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> OR10217 O'Reilly Auto Parts <br /> 233 S Patterson Ave <br /> Attn John Bounds <br /> Springfield <br /> MO 65802-2210 <br /> PHONE 417-520-4589 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/PRODUCT QTY UNIT PRICE TAX TOTAL CHARGE <br /> 3383 DRUM, 55GA OIL FILTER, DROP OFF 1.0 TIER1 TIER1 TIER1 <br /> 8003369 DRUM, 55 GL BLACK STEEL OH RECON 1.0 TIER1 TIER1 TIER1 <br /> 83383 DRUM, 55GA OIL FILTER WASTE, PICK UP 1.0 TIER1 TIER1 TIER1 <br /> SERVICE TERM 0 WEEK <br /> 875460/ 40559605 CNO-NON HAZARDOUS SOLID 55GL 1.0 TIER1 TIER1 TIER1 <br /> SERVICE TERM 12 WEEK <br /> CONT#: 1 TSDF:GM MANIFEST#: FORM CD:US SHIP#: 236587039 <br /> 008315332SKS <br /> CNT#: 220310105678 QTY: 150 WT/VOL P PROF#:40559605 SKDOT#: 7361257 <br /> 100001 FEE, FUEL SURCHARGE 1.0 TIER1 TIER1 TIER1 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 1.0 TIER1 TIERI TIER1 <br /> TOTAL SERVICE/PRODUCTS <br /> TIER1 TIER1 TIER1 <br /> TOTAL CHARGE TIER1 <br /> CREDITS TIER1 <br /> ------------------------------ <br /> TOTAL DUE TIER1 <br /> ------------------------------ <br /> UNPAID BALANCE THIS RECEIPT TIER1 <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Customer 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 /> Department of Transportation (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 (b) any SK agreement signed by Customer and SK, and (2) incorporated herein <br />