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BRANCH 116501 CSG 22 COLEMAN,#!LL I Ai 02/10/04 08:55 PAGE 1 <br />Safety-Kleen <br />5400 Legacy Or, <br />Cluster II, Building 3 <br />Plano, Texas 75024 <br />209-545-1011 <br />REFERENCE NBR <br />CUSTOMER# 371796 FOX RIVER PAPER CO - RIPON 0025576319 <br />SERVICE TAX: 0.07750 942 S STOCKTON AVE SRVC WEEK: 04-06 <br />COMS TAX: 0.00000 ATTN: ACCTS PAYABLE SRVC DATE: 02110104 08:46 <br />PRODUCT TAX: 0.07750 RIPON CA 95366.2784 <br />PHONE 209-599.4241 <br />PURCHASE ORDER# 19905 TAX EXEMPTION NBR: <br />PRODUCT/SERVICES <br />SERV ICE I <br />PRODUCT <br />SER IAL# <br />00 3230 TAX HANDLING NIC DRUM DROP <br />00 100001 TEMPORARY FUEL SURCHARGE <br />00 7530 SORBENT SVC 55 PADS <br />DO 88886 83337 DRUM,55 WASTE-SORBNT <br />2273729 CLEAN 0 SPENT 0 <br />SERVICE TERM 2 <br />TOTAL SERVICEIPRODUCTS <br />TOTAL <br />QTY UNIT PRICE TAX CHARGE <br />1 0.0000 0.00 0.00 <br />1 5,9000 0.00 5.90 <br />1 549.0000 0.00 549.00 <br />1 0,0000 0.00 0.00 <br />----------------------------------------- <br />554.9000 0.00 554.90 <br />USEPA TRANSPORTER 1 TXR000050930 GENERATOR USEPA CAD009119314 <br />USEPA TRANSPORTER 2 GENERATOR STATE <br />MANIFEST DOC # 23020820 FORM CODE CA TRACKING # 104470238 <br />US DOT DESCRIPTION (INCLUDING PROPER SNIPPING NAME, HAZARD CLASS, AND ID <br />TOTAL CONT 1 TYPE DM TTL QTY 260 UNIT WT/VOL P SKOOT 19027 <br />CONTAINER# 40209003844 QTY 260 <br />DESIGNATED FACILITY NAMEIADDiESS: <br />SAFETY-KLEEN SYSTEMS, INC, <br />3700 LAGRANGE ROAD <br />SMITHFIELD KY 40068 <br />USEPA ID NO KYD053348108 TOTAL CHARGE 554,90 <br />STATE ID NO WASTE MIN 0.00 <br />TOTAL DUE 554.90 <br />Machine clean and good condition? Yes <br />Decals in place and legible? Yes <br />Fusible link installed? Yes <br />Emergency closing of lid unobstructed? Yes <br />Machine properly grounded? Yes <br />Spent solvent meets acceptance criteria? Yes <br />GENERATOR STATUS 220 - 2200 lbs/month <br />Customer certifies that (i) the above-named materials are properly <br />classified, packaged, marked and labeled, and are in proper condition <br />for transportation according to the applicable regulations of the <br />Department of Transportation and (ii) no material change has occurred <br />either in the characteristics of the waste materials or in the process <br />generating the waste materials. Customer agrees to pay the above <br />charges and to be bound by the terms and conditions (1) set forth in (a) <br />the General Terms and Conditions provided separately to Customer or <br />(b) any SK agreement signed by Customer and SK, and (2) incorporated <br />herein by reference. Unless otherwise indicated In the payment <br />received section. SK is authorized to charge Customer's account for this <br />transaction. Customer certifies that the individual signing this Service <br />Acknowledgement is duly authorized to sign and bind Custwer. <br />IN THE EVENT OF AN EMERGENCY CALL 1-800-468-1760 (24 hours) <br />SIGNATURE NAME: PETER PERTONIS <br />LAST PAGE <br />