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CSG SK-SSL-BOX-21 Gaither,Brandon J 02-02-2021 10:30 PAGE 1 V-4.1 Safety-Kleen Systems, Inc. 42 Longwater Drive Norwell, MA 02061 CORPORATE: 800-669-5740 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) 2095451011 REFERENCE HER. CUSTOMER# BR26816 Brocchini Farms Inc 85219640 - 2100173121 27011 S Austin Rd SRVC WEEK: 2021-6 Ripon SRVC DATE: 02-02-2021 CA 95366-9625 PHONE 209-599-4229 BILL TO CUSTOMER# BILL TO ADDRESS: ER26816 Brocchini Farms Inc 27011 S Austin Rd Ripon CA 95366-9625 PHONE 209-599-4229 PURCHASE ORDER# TAX EXEMPT# PRODUCT/SERVICES SERVICE/PRODUCT QTY UNIT PRICE TAX TOTAL CHARGE 90837 MODEL 90 W/2387 & 6365 1.0 410.0 1.0 441.78 SIN 90209368 TAG t0000O00xx9O209368 CLEAN 2.5 SPENT 0.0 SERVICE TERM 8 WEEK SCANNED NO 100030 RECOVERY FEE 1.0 26.65 2.07 28.72 TOTAL SERVICE/PRODUCTS 436.65 33.85 470.50 TOTAL CHARGE 470.50 CREDITS 0.00 ------------------------------ TOTAL DUE 470.50 ------------------------------ UNPAID BALANCE THIS RECEIPT 470.50 Spent solvent meets acceptance criteria? Yes Local Phone No. Sticker Affixed to Machine Yes Machine properly grounded? Yes Emergency closing of lid unobstructed? Yes Fusible link installed? Yes Decals in place and legible? Yes Lamp Assembly Condition Yes Machine clean and good condition? Yes GENERATOR STATUS 220-2200 lbs/month I have established a program to reduce the volume above-named materials are properly or quantity and toxicity of the hazardous waste to the degree to be economically practicable. labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation (ii) no material change has occurred either in the characteristics of the waste/material or in the process generating the waste/material, and (iii) the above referenced Generator Status is correct. Customer agrees to pay the above charges and to be bound by the 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 SK, and (2) incorporated herein by reference. Unless otherwise indicated in the payment received section, SK is authorized to charge Customers account for this transaction. If Customer fails to make payment when due, an amount equal to the lesser of (i) 1.5% per month (18% per annum) or (ii) the maximum amount allowed by law, will be added to all unpaid amounts outstanding. Customer certifies that the 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 number if required by applicable law. The following provision is applicable to Safety- Kleens parts cleaner and paint gun cleaner services: Customer agrees that it will not introduce any substance into the solvent or aqueous cleaning solution, including without limitation any hazardous waste or hazardous waste constituent, except to the extent such introduction is incidental to the normal use of the machine. Customer further agrees that it will not clean parts/paint guns that have been contaminated with or otherwise introduce polychlorinated biphenyls (PCBs), herbicides, pesticides, dioxins or listed hazardous waste into the solvent or aqueous cleaning solution. Safety-Kleen 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 perchloroethylene, petroleum naphtha, or triflurotrichloroethane dry cleaning solvents. Customer agrees that it is responsible for properly classifying its waste streams as Used Oil or Nonhazardous Waste in accordance with the provision of 40 CFR 262.11 and applicable state laws. Customer agrees that it will not introduce any non-conforming substance into the SK Property, including, without limitation, any hazardous waste or hazardous waste constituent,(i.e., polychlorinated biphenyls ("PCBs"), herbicides, pesticides, dioxins, or listed hazardous wastes) except to the extent such introduction is incidental to the normal use of the SK Property. In the event of the introduction of such non-conforming hazardous waste, Customer agrees that it will be responsible for all costs and remediation expenses related to or arising from the proper management and disposal of the non-conforming waste, including the cost of equipment decontamination and subsequent disposal. Final invoicing will be based on the actual services provided, which may include additional charges for off specification waste and surcharges. Final invoice amount may be more than the amount listed on the printed receipt. If any legal action is commenced because of an alleged dispute, breach, default or misrepresentation, the