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OVZ7/2014 TUE 16! 21 FAX (Q�O14/QZ5 <br /> CSG SK-SSL-BOX-23 Raymond Gomez 08/31/17 10:2e PAGE 1 <br /> afety-Mean Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Rlchardsor, TX 75080 <br /> CORPORATE: ROO-664-5740 <br /> 24 IR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2098451011 <br /> REVERENCE NBR. <br /> CUSTOMERA 5021038 Bobs Lube 6 Smog 74613356-1704303704 <br /> 1403 Country Club Blvd BRVC WEEK: 2017-35 <br /> Stockton CA 95204-4910 SRVC DATE: 08/31/17 <br /> PHONE 209.943-3633 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> 8022519 Bobs Lube & Smog <br /> 1403 Country Club Blvd <br /> tockton CA 95204-4910 <br /> PHONE 209-943-3633 <br /> PURCHASE ORDERN TAX E.XE)MPT# <br /> PRODUCT/SERVICES <br /> SFRVTCF/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 95 <br /> 98800 AQ1 SERVICE ITN 6365 1.000 3"14.2300 2b.'13 349.36 <br /> S/N 9030008 TAC 00098000SK09030008 CLEAN 1.00 SPENT 0.000 <br /> SERVTCF TFR 1.7. WEED( SCANNED YES <br /> 100001 FEE, FUEL SU CHARGE 1.000 10.5000 0.01 11.31 <br /> ----------------------------------------- <br /> TO'M, !ERV WPRODUCTs 334.7300 25.94 360.67 <br /> TOTAL CHARGE 360.67 <br /> CREDITS 0.00 <br /> TOTAL DUE 360.67 <br /> --------------- <br /> UNPAID 9ALANCR HIS RECEIPT ;160.67 <br /> Machine clean and good condition? Yee <br /> Lamp Assembly Conditioi Yes <br /> Dpre1R in place and le able? Yee <br /> Fusible link installed' Yen <br /> Emergency closing of 1 d unobatructed? Yes <br /> Machine properly groun ed? Yea <br /> Local Phone No. St.icka Affixed to Machi.nc Yas <br /> Spent solvent meets ac eptance criteria? Yes <br /> GENERATOR STATUS <br /> 0-220 I.bs/month <br /> Customer certifies that li) the above-named materials are properly <br /> classified, packaged, m rked and labeled, and are in proper condition <br /> for transportation acco ding to the applicable regulations of the <br /> Department of Tranapert tion (11) n0 material change has occurred <br /> either in the GharaC'or atica of the wsete/material or in the process <br /> generatinq the waste/ma erial, and (ili) the above referenced <br /> Generator Status •ts cor cct. Customer agrees Vu pay the above charges <br /> and to be bound by the arms and condttions (1) :vet. f.orLh In (a) Lhe <br /> General Terms and Condi lona provided saparataly to Cnstnmer or (b) <br /> any SK agreement signed by Customer and SR, and (2) incorporated <br /> herein by reference. U less otherwise indicated in the payment <br /> received section, SK ie authorized to charge Customer's account for <br /> thin Lrnrinaction. If Cu tomer fails to make payment when due, an <br /> amognt nqunl Lo (:he leer ter or (1) 1.56 per month (18% per annum) or <br /> M) tho maximum Amount. allowed by few, will be added to all unpaid <br /> amounts outstanding. Cu tomer Certified that the individual signing <br /> this Service Acknowledg mcnt is duly outharited to sign and bind <br />