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BRANCH /192 CSG 21 pflOres, 07/28/10 13:17 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 5350 Legacy Drive. E <br /> Building 2, Suite 100 O <br /> Plano, Te..a 75029 <br /> 800-669-9710 <br /> 209-595-1011 <br /> REFERENCE MBO. V d <br /> CUSIBMtR$ 371161 SAM JOAQUIN HEGIONAL TRANSIT U 51628187 N <br /> 1533 E LINDSAY ST SWC WEEK: 2010-31 Y <br /> ATTN TRANSIT DISTRICT SHVC DATE: 07128/10 13:16 , <br /> SWITCH CA 95205-4417 P <br /> PHONE 209-998-5566 <br /> PURCHASE ORDER. p109162 I" EXEMPTION NBR 41- <br /> PRODUCT/SERVICES <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL 3 <br /> PRODUCT QTY UNIT PRICE TAX CHARGE 3 <br /> 12063/ ; <br /> 875060 FUEL BLEND SOLID / PAINT 1.001) 366.0000 0.00 366.00 <br /> SERVICE TERN 8 <br /> PROMO NOR: 0 <br /> e LONIS: 1 TSUF: 121994MANIFESIa 00335/4106fle FORM (U: US Sk SHIP. 101568192 <br /> CNTW: 10012/925631 QTY: 100 WI/VOL P PROFILE: 012063 SKDOT 100558 <br /> . - _-------------------- <br /> TOTAL SERVILCE/PHODUCTS 366.0000 0.00 366.00 <br /> TOTAL CHARGE 366.00 Vwar <br /> 1 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 366.00 \ <br /> UNPAID BALANCE THIS RECEIPT 366.00 E <br /> O <br /> Y <br /> G <br /> d <br /> d <br /> Y <br /> GENERATOR STATUS T <br /> 0 - 220 lbs/month <br /> as <br /> Custm.mr certifies that (i) the abov.-..,.,l materials are properly W <br /> y and are i proper condition r� <br /> Classified. pack. eJ, marked end labeleA, n pr p m <br /> for transportation according to the applicable regulations of the y <br /> Department of Transportation and 01) no material change has occurred 3 <br /> either in the dlar.c I.ristics of the waste/owterial or in the process <br /> ....rating the waste/loafer ial. Coslun.er agrees to Paythe above <br /> m <br /> charges and to be bound by the ters and conditions (1) set forth in ; <br /> (a) the General Terms and Conditions Provided aparately to Custo.ner \ <br /> or (b) any SK Four...ant signed by Customer and SK, and (2) \ <br /> incorporated h.rein by reference. Unless otherwise indicated in the <br /> ,replant received section, SK is authorized to charge Custonrer's <br /> account for this transaction. Custerner certifies that the individual <br /> signing this Service Acknowledyement is duly authorized to sign and s <br /> bind Costumer. Tire following provision is applicable to Safety-Kleen's <br /> parts cleaner and paint gun cleaner services: Customer .trees that it <br /> will not introduce any substance into the solvent or aqueous cleaning aw <br /> solution, including without limitation any hazardous waste or ve <br /> hazmvlos r:nzte umstitoert . mpt to thr -cn-et ".1, introduction iz <br /> incidental to the normal use of the finer-hive. Custmner further agrees <br /> that it will not clean parts/paint tuns that bay. be.n c.ntanlin.ted <br /> with or Otherwise introduce polychlorinated biphenyls GCB's). E <br /> herbicides, pesticides, diosins or listed hazardous ...te into the O <br /> solvent O aqueous cleaning solution. Safety-Kleen has the cavae it, Y <br /> and is permitted to accept, store, end/or reclaim the spent parts <br /> washer solvent paint thinners, solvent. aad paints Venerated by C <br /> customer: or dry cleaning filter cartridges, powder, and still d <br /> residues containing perchloroethylene, petrol.... naphtha, or FLO <br /> triflurotrichl Oroethmla dry cleaning solvents. Safety-KTeee And y <br /> customer, agree that this agreen.ent is intended to satisfy the I <br /> requirements of 90 CFR 262.20(.). IN IRE EVENT OF AN EMERGENCY CALL T <br /> 1-800-968-1760 (29 hours) Y <br /> d <br /> % <br /> w <br /> A <br /> N <br /> 3 <br /> l <br /> \ <br /> CUSTOMER / GENERATOR :noug Smith <br /> LAST PAGE b1 <br /> \ <br />