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CSG SK-SSL-BOX-24 Maebe—Y,Bruce 11-30-2023 11.18 PAGE 1 V-8.3.1 Safety-Kleen Systems, Inc. 42 Longwater Drive Norwell, MA 02061 CORPORATE; B00-669-5740 24 HR EMERGENCY: 800-468-1760 )Safety-Kleenp 2095451011 REFERENCE NBR. CUSTOMERR CA46227 Caiififornia Highway Patrol 93186642 - 2305959384 2720 Wilcox Road SRVC WEEK; 2023-48 Stockton SRVC DATE: 11-30-2023 CA 95215-2241 PHONE 209-938-4819 BILL TO CUSTOMER# BILL TO ADDRESS: CA46227 Calififornia Highway Patrol 2720 Wilcox Road Stockton CA 95215-2241 PRONE 209-938-4619 PURCHASE ORDER# TAX EXEMPT# PRODUCTISERVICES SERVICE/PRODUCT OTY UNIT PRICE TAX TOTAL CHARGE 8863 GASTEC AQUEOUS PW SAMPLE TUBE 1,0 0.00 0.00 0.90 SERVICE TERM I WEEK Scanned: NO 90837 MODEL 90 W/2387 d 6365 1.0 239.0 18.52 257.52 $IN B034100 TAG 00001170SK08034100 CLEAN 1.7 SPENT 0.0 SERVICE TERM 8 WEEK SCANNED YES PERC TEST: PASS 100005 CHEMISTRY FEE 1.0 0.00 0.00 0,00 TOTAL SERVICE/PRODUCTS -----------------------------'-----_-----------------__------------------ 239.00 19.52 257.52 TOTAL CHARGE 257.52 CREDITS 0.00 .... TOTAL DUE ^ »M1-----257.52 ----------------- UNPAID BALANCE THIS RECEIPT 257.52 Spent solvent meets acceptance criteria? Yes Local Phone No. Sticker Affixed to Machine Yes Machine properly grounded? Yes Fanergency 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 0-220 lbs/month Customer certifies that (i) the above-named materials are properly classified, packaged, marked and 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 11) 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 Ill 1.5& per month (ln 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. The receiving facility has the appropriate permit(s) for, and will accept, the waste the generator 18