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CSG SK-SSL-BOX-21 Camacho,Jose 01-07-2022 16:02 PAGE 1 V-6.1 <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 HER. <br /> CUSTOMER# BR26816 Brocchini Farms Inc 87906650 - 2106296606 <br /> 27011 S Austin Rd SRVC WEEK: 2022-1 <br /> Ripon SRVC DATE: 01-07-2022 <br /> CA 95366-9625 <br /> PHONE 209-599-4229 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> ER26816 Brocchini Farms Inc <br /> 27011 S Austin Rd <br /> Ripon <br /> CA 95366-9625 <br /> PHONE 209-599-4229 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/PRODUCT QTY UNIT PRICE TAX TOTAL CHARGE <br /> 8863 GASTEC AQUEOUS PW SAMPLE TUBE 1.0 6.00 0.47 6.47 <br /> 90837 MODEL 90 W/2387 & 6365 1.0 410.0 31.78 441.78 <br /> S/N 19470 TAG TOOOOOOOXX90209368 CLEAN 2.5 SPENT 0.0 <br /> SERVICE TERM 8 WEEK SCANNED NO <br /> PERC TEST: PASS <br /> 100030 RECOVERY FEE 1.0 47.84 3.71 51.55 <br /> TOTAL SERVICE/PRODUCTS <br /> 463.84 35.96 499.80 <br /> TOTAL CHARGE 499.80 <br /> CREDITS 0.00 <br /> ------------------------------ <br /> TOTAL DUE 499.80 <br /> ------------------------------ <br /> UNPAID BALANCE THIS RECEIPT 499.8 <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 /> 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 make payment when due, an amount equal to the lesser of (i) 1.5% 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 /> acknowledges 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 will not introduce any substance into the solvent or aqueous cleaning solution, including without <br /> limitation any hazardous waste 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 waste into the solvent or aqueous cleaning solution. Safety-Kleen has the capacity and is permitted to accept, <br /> store, and/or reclaim the spent parts washer solvent; paint thinners, solvents and paints generated by customer; or dry <br /> cleaning filter cartridges, powder, and still residues containing perchloroethylene, petroleum naphtha, or <br /> triflurotrichloroethane dry cleaning solvents. Customer agrees that it is responsible for properly classifying its waste <br /> streams as Used Oil or Nonhazardous Waste in accordance with the provision of 40 CFR 262.11 and applicable state laws. <br /> Customer agrees that it will not introduce any non-conforming substance into the SK Property, including, without <br /> limitation, any hazardous waste or hazardous waste constituent,(i.e., polychlorinated biphenyls ("PCBs"), herbicides, <br /> pesticides, dioxins, or listed hazardous wastes) except to the extent such introduction is incidental to the normal use <br /> of the SK Property. In the event of the introduction of such non-conforming hazardous waste, Customer agrees that it will <br /> be responsible for all costs and remediation expenses related to or arising from the proper management and disposal of <br /> the non-conforming waste, including the cost of equipment decontamination and subsequent disposal. Final invoicing will <br /> be based on the actual services provided, which may include additional charges for off specification waste and <br />