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{ UHANCH i 14 I CSG Z4 ULACK,UAAMUN 10116107 15:01 PAGE 1 . Safety -Kleen 5400 Legacy Or, Cluster II, Building 3 Plano, Texas 75024 • 209.545.1011 REFERENCENBR CUSTOMER# 370802 UNITED AUTO RPR 0035074975 SERVICE TAX: 0.08000 400 N. EL DORADO ST SRVC WEEK: 07-42 COMS TAX: 0.00000 SRVC DATE: 10116107 14:21 E PRODUCT TAX: 0,08000 STOCKTON CA 95202 c PHONE 209-941-8218 u PURCHASE ORDER# TAX EXEMPTION NBR: PRODUCT/SERVICES . SERVICE/ TOTAL PRODUCT QTY UNIT PRICE TAX CHARGE 100008 FEE, CALIFORNIA FUEL NON TA 1 15.0000 0.00 15.00 �+ 53835 COMS MDL 53 AQ/6306 1 237.7500 0.00 237.75 w 40 SIN 448586 CLEAN 3 a SPENT 0 SERVICE TERM 16 1O 51830 COMS MDL 51 AQ/6317 1 123.9500 0.00, 123.95 3 SIN 48587 CLEAN 2 SPENT 0 3 SERVICE TERM 16 ----- ----------•------------------- 3 TOTAL SERVICE/PRODUCTS 376,7000 0.00 376.70 USEPA TRANSPORTER 1 TXR000050930 ,.• GENERATOR ID CAL000074469 USEPA TRANSPORTER 2 GENERATOR STATE MANIFEST TRACKING # 000636140S FORM CODE 1D US OOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID NON-RCRA HAZARDOUS WASTE, LIQUID (AQUEOUS PARTS WASHER SOLUTION) TOTAL CONT 2 TYPE DM Tfl- QTY 43 ? UNIT WT/VOL G SKOOT 14941 CNT# 70922061411 QTY 25 WASTE CODE CA 134 CA CAT G CNT# 70922061412 QTY 18 WASTE CODE CA 134 DESIGNATED FACILITY NAME/ADDRESS: SAFETY-KLEEN SYSTEMS, INC, E E 6000 88TH STREET u SACRAMENTO ( CA 95828 aci USEPA 10 NO CA0000084517 TOTAL CHARGE 376.70 :r STATE ID NO WASTE MIN 0.00 Y TOTAL DUE 376.70 +' UNPAID BALANCE THIS RECEIPT 376.70 w Machine clean and good condition? Yes .' Decals in place and legible? Yes 3 Fusible link installed? Yes ; Emergency closing of lid unobstructed? Yes f Machine properly grounded? Yes \ Spent solvent meets acceptance criteria? Yes Prop 65 warning (Calf. only)? Yes i GENERATOR STATUS 220 - 2200 lbs/month.. �. The generator has established a program to reduce the vuIume or quantity and toxicity of the hazardous waste to the degree, as determined by the generator, to be economically practicable. 4, Customer certifies that (1) the above-named materials are properly classified, packaged, marked and labeled, arkl are in proper cundIIion for transportation according to the applicable regulations of the Department of TranspurtaIiun and (1i) nu material change has occurred :u either in the characteristics of the waste/material or in the process • generating the waslelmaterial. Customer agrees to pay the above C charges and to be bound by the terms and conditions (1) set forth in (a) v I the Lieneral 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 payuwnt received section, SK is authorized to charge Customer's account for this: transaction, Custumer certifies that the individual signing this Service w Acknowledgement is duly authorized to sign and bind Customer. 4• The following provision is applicable to Safety-Kleen's parts cleaner and w paint gun cleaner services: Customer agrees that it will not introduce any ; i substance into the solvent ur aqueous cleaning solution, including without ; limitation any hazardous waste or hazardous waste constituent, except toll*'•:extent such introduction is incidental to the normal use of the machine. Customer fu then agrees that it will not clean parts/paint guns r that have been contaminated with or otherwise intruduce polychlorinated 8: b4RRI*nyls-(PCB's), herbicides, pesticides, dioxins or listed hazardous _! waitec`into the solvent or aqueous cleaning solution. IN THE EVENT OF AN EMERGENCY CALL 1-800-468.1760 (24 hours) SIGNATURE A�1E: TEDDY NGUYEN - E > 0 C d