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Safety-Kleen <br /> rAwk <br /> Ciusterr 111.00 Legacy <br /> Plane, Texas 75FF '1$ <br /> 209-545-1011 REFERENCE NBR t <br /> R# 3264ti611 [RACY CHRYSLER JEEP OWSRUC WEEK: 08-45 Oo37702146 E <br /> ICF TAX: 0.07750 3450 NAGLEE RD SRVC DATE: 11112108 14:44 <br /> L(1MS <br /> TAX: 0.00000 CA 95304 <br /> PRODUCT TAX: 0.07750 TRACY <br /> PFIONE 209-820.180041 <br /> PURCHASE ORDER# 70530 TAX EXEMPTION NOR: <br /> x <br /> PRODUCT/SERVICES TOTAL <br /> SERVICE[ QTY UNIT PRICE TAX CHARGE <br /> PRODUCT 0.0040 0,00 0.00 �- <br /> 2387 HEATER-PUMP-MODULE ASSEMBLY 1 14.8000 1.15 15.95 N <br /> 100009 FUEL FEE SURCHARGE 1 191.5900 14.65 205.44 <br /> 90837 MODEL 90 W12387 & 6317 SPENT 0 <br /> SIN 11288 TAG TOU00008UXX902o%58 CLEAN 5 <br /> SERVICE TERM <br /> 90837 MODEL 90 W12387 & 6317 1 191.5900 14.85 2U6.44 <br /> SIN 50879 G TERM <br /> TOOO$XX902U9657 CLE <br /> SERVICE <br /> 5 <br /> SPENT 0 <br /> 1 0.0000 0.00 0.00 <br /> 92387 2387 pUMp ASSEMBLY SPENT 0 x <br /> SIN 08f12150SERVTAG CE TERM 885KpREV1SERIAL#EAN 0 87011288 <br /> CAUSE CODE 4 10.0000 0.00 0.00 <br /> 92387 2387 PUMP 93`SEMBLY SPENT 0 <br /> 51N Ua01s15TAG SERVILE TERM 8SKPREV3SERIAL 487050879 <br /> r <br /> CAUSE CODE 4 ----------------- -.- - <br /> TOTAL SERVICEIPRODUCTS 397.9800 30 85 428.83 c <br /> USEPA IRANSPOR1tA 1 1XR000050930 GLNkRATOR ID CALOOD332366GENERATOR STATE a <br /> USEPA TRANSPORTER 2 d <br /> MANIFEST TRACKING # 0015512MS FORM CODE 1D <br /> US 110 ttSCHIPIION (INCLUDING PHUPEH `UH1pPiW NAML, HALAHU CLASS, AND Ili <br /> NON-RCRA HAZARDOUS WASTE, LIQU10 *' <br /> (AQUEOUS PARTS WASHER SOLUTION) UNIT WTIVOL G SKUOf 14941 <br /> TOTAL CONT 2 TYPE DM TTL <br /> QTY <br /> TL CODE CA 134 CA CAT G vi <br /> CNT# 61018060435 QIY 25 WASWASTE CODE CA 134 ; <br /> CNT# 81018060436 QTY 25 <br /> DESIGNATED FACILITY NAMEIADORFSS 3 <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 6000 BATH STREET <br /> SACRAMENTO CA 9582a m <br /> TOTAL CHARGE 428.83 <br /> USEPA ID NO CAO000084517 WASTE MIN0.00 <br /> STATE ID NO ----�---- -- <br /> TOTAL DUE 428.83 <br /> UNPA@ BALANCE THIS RECEIPT 428.63 E <br /> O <br /> Machine clean and good condition? Yes <br /> u <br /> Decals in place and legible? Yes <br /> Fusible link installed? Yes m <br /> Emergency closing of lid unobstructed? Yes <br /> Machine properly grounded? Yes s <br /> Spent solvent meets acceptance criteria? Yes <br /> Prop 65 yarning (Calf. anly).? Yes 4r <br /> +r. <br /> +s <br /> GENERATOR STARTS 220 - 2200 lbs/month w <br /> The generalur has established a prug,am to reduce the volume or <br /> 3 <br /> yuanlity and toxicity of the ha"'cluus was le to the deg , as tJelermined <br /> by the generator, to be ecattomically practicable. i <br /> Cuslwrer certifies that (i) fire above-named materials are properly <br /> classified, I�ac4aged, mraiked and labeledand are ill p+u[rer cortdiliun m <br /> fur tcausportation according la the applicable regulations of the r <br /> Depai Lrent of Ti anspoa taLion and (i i) rao mater ial Charxye has occur red <br /> either 1n LI-re cl+aiacter istics of the was telmaterial or in the process <br /> generating the was lelmaterial. Customer agrees to pay the above <br /> charges and lu be bound by the terms arKt conditions (1) set fug(1) in (a) <br /> the General Teras and Cunditiuns provided separately to Customer or <br /> (b) any SK agieement signed by fustuzrer -and SK, and (2) incoiporaled Z:z <br /> herein by reference. Unless ulherwise indicated in the payment <br /> rN,wM1 rl mer SVf ie •auHuvirerT lu cliarne Cuslumer's accuunt fui this <br />