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��► C ITD <br /> JUL 0 9 'NIB <br /> CSG SK-SSL-UMO-01 Joseph R Lima Sr 02/05/18 13:26 PAGE 1 ENVIRONMENTAL <br /> Hl AUTU D�PP.R["ENT <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NEE. <br /> CUSTOMER# KI18312 Kia Country 76058290 <br /> 1515 N Main St SRVC WEEK: 2016-6 <br /> Manteca CA 95336-3243 SRVC DATE: 02/05/18 <br /> PHONE 999-999-9999 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> KI18312 Kia Country <br /> 1515 N Main St <br /> Manteca CA 95336-3243 <br /> PHONE 999-999-9999 <br /> PURCHASE ORDER# 2-5-18 TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 10256 FEE, OIL SERVICE/STOP NON 1.000 0.0000 0.00 0.00 <br /> SERVICE TERM 4 WEEK <br /> 66636 USED OIL RECYCLE AUTOMOTI 335.000 0.0000 0.00 0.00 <br /> SERVICE TERM 4 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPM < 1000 <br /> _____-________ <br /> TOTAL SERVICE/PRODUCTS 0.0000 0.00 0.00 <br /> TOTAL CHARGE 0.00 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 0.00 <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT 0.00 <br /> If high risk source, rep. certifies that load specific PCB 6 Silicon <br /> testing have been completed prior to pumping this load. <br /> GENERATOR STATUS <br /> CESQG: Vehicle <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 (ii) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material, and (iii( the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to be bound by the terms and conditions (1) set forth in (a) the <br /> General Terms and Conditions provided separately to Customer or (b) <br /> 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 <br /> this transaction. If Customer fails to make payment when due, an <br /> amount equal to the lesser of (1) 1.5% per month (18% per annum) or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> amounts. outstanding. Customer certifies that the individual signing <br /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer. Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law. The following provision is applicable to <br /> Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br />