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-23 David L Buxton 09/14/15 11:08 .PAGE 1
<br /> Safety-M een Systems, Inc, �
<br /> 2800 N Central Fxpy, Suite 200
<br /> Richardson. 7X 75080
<br /> CORPORATE: 809- 40 `
<br /> - 24 NR EMERGENCY; 800-468-17601760 (Safety-Klaen) ,V{
<br /> 2095451011
<br /> REFERENCE NBq,
<br /> CUSTOMER# S729808 Stockton Rubber Mfg Co Inc. 67899996
<br /> 5023 N Flood Rd SRVC WEEK: 2015-37
<br /> Linden CA 95236-9455 SRVC DAiS: 09/14/15 11:08
<br /> PHONE 209-887-1172 L
<br /> BILL TO CU5T0MER0 BILL to At
<br /> Rubber
<br /> 5729808 Stockton Robber Mfg.Co Inc V `�{•t'
<br /> 5023 N Flood 9
<br /> Linden CA 152323 6-9455
<br /> PHONE 209-887-1172
<br /> PURCHASE ORDER* TAX EXEMPTS
<br /> PRODUCT/SERVICES Av
<br /> SERVICE/ TOTAL
<br /> PRODUCT QTY UNIT PRICE TAX CHARGE
<br /> 13131 GUMS SEC W/CLEAR CHUXE' 1.000. 314.8400 0.00 314.84
<br /> SIN 13053534 CLEANj,QOO,SPENT 0.000,
<br /> SERVICE TERM 8 WEEK
<br /> CSM REMARKS N/A
<br /> 100001 FEE, FUEL SURCHARGE 1.000 10.8300 0.00 10.83
<br /> TDI-AL SEBVICE/PRODUCT5 - 32S.6700 0.00 325.67
<br /> TOTAL CHARGE 32S,07
<br /> CREDITS 0.00
<br /> ---------------
<br /> 70TAL DUE 329•:67
<br /> UNPAID BALANCE THIS RECEIPT 325.67 -
<br /> Is the Gun cleaner properly grounded to protect against static
<br /> electricity?Yes
<br /> Is the exhaast 'It piping from this Gun Cleaner vented directly REC
<br /> 'bootiaors or is 4.t veuted into (OR' lucaterl insidro) the paint spray
<br /> booth? Yes
<br /> tu
<br /> Machine clean and good condition? Yes CEP 3 0 20 16
<br /> "Leap Assembly Condition Yes J
<br /> Decals in place and legible?Yes
<br /> Fusible link installed?Ye'
<br /> Emergency closing of lid unobstructed?Yes
<br /> Local
<br /> properly grounded? Yes
<br /> ENVIRON
<br /> HEALT
<br /> j' Local Phone No. Sticker Affixed to Machine Yes
<br /> Spent solvent meets acceptance criteria? Yes #EPARTMENT
<br /> GINERA70R STATUS
<br /> 0-220 lbs/mooth
<br /> Customer certifies that (i) the above-named mat_rials are properly
<br /> rla+sifis4t, I,d.laged; o.;,rk.J anal labrle.l. 4.111 ora Iw pr.,h,er .urn 11 i....
<br /> roe tr,9nspurl al inn ar,arding to the appl is dial. rivulet iunc of the
<br /> Oetmr tment. of Traaspvr•ldt ion and flit rtt,Incl m•i:al eh-ngr hes Ptaut•rwl
<br /> either- in tlw thar•,94.ter ist ics of Lire waste/materiel ur in the pru4.esf+
<br /> gentratirig the w'al LC/ImuLCr•ial. Custarmur.agrces to I14y the dbeVC
<br /> thar•ges and to be bound by the tertius and cvnditivns (1) act furth in
<br /> (.) tInc General Tovi. aqd fnnd;t ions prrvidrd paporately 10 Co.tran.rr
<br /> or (b) any SK agreement signed by Customer and 5K, and (2).
<br /> incorporated herein ht referrnra. HnlPss ache-ine indicated in the
<br /> Paymont received sectiten. SK is authorized to charga CusLoruer•'s
<br /> _ ccotnrt for this transaction. If 4»tmmer fails to make payn,.nt e.'hen
<br /> due, an amount equal to tha lesser of Ci) 1.5%Wer month an par
<br /> armwu) or (ii) the mdai.nln,a11NNy! .11nwcrl by law, will be nddnd t., all
<br /> nnpa id .Ymrrrnt% nuI%tandirg, rertif;rs than the I.r.16'.hwl
<br /> igning ffiia Service Arkanwlydat,wnt is duly aathur"iced to ciun ...d
<br /> bind Cuslaller. the fulluwirW pruvisiau is app'lic,9bie to Safety-Klaan's
<br /> Par." Oreaner add paint Yuji cleaner survites; Custmaer agr'eab that it 1
<br /> Will not iulruduce any auhstariusinto the O4plVll11t OP 0414e6111} 4.101,91141V ('
<br /> solution, irralodi,rg without lin+itation any hdzar'dous waste o.r
<br /> i:c -- .
<br /> incidental Lee the nurvral use of the nidLhine. Cu iregicr further- agrees•+ {
<br /> t.Ial it will ret al.aa parts/paint Owns that have been ront.eninated -with or otherwise introduce.Palychlorinated biphenyls-(PCB's),
<br /> llgrbieidrs, IWSllairl►A, dioxins or listed Irdrarduus'wdste 1111" the [
<br /> solvent ur aqucuus cleaning sul.atiun. Safety-Klcan has the capacity
<br /> and is permitted to accept, stere. ander reclalin the apent:`parts
<br /> Washer solvent; paint thinners, solvents and paints generated by
<br /> customer; or dry cleaning filter cartridges, powder, and still
<br /> residues crultaining ptrchloroothylone, petroleum aaphtlra, or
<br /> 2.-iila:ai:i-hla:cci.`. .c r -'cwa=- - 1.ca2 :st"; d
<br /> •.ci
<br /> i - • u- > s,
<br /> is r•asponsible fur pruper'ly Llassiryiny its was Le sLrealeu as CU ad oil
<br /> ur Nnnhazardnas Wdsty is ecrorvt,9rrce with the I:e'ovisian of{0 CFR
<br /> 262.11 and applicable state laws. Custolller agrees that`it will naL
<br /> introduce waY nun-coefnrxriny substance intra the SK Prupe.1ty,
<br /> constituent,(i.e., polychlorinated biphenyls ('PCBs'), herbicidesay-
<br /> • hazzr4ui Wastci) `-ccpi t- - v -:...`
<br /> -;:C:: i:.trc.::ciiar. i- ir.:idzrtal t3 tthze nrrrn j u-' -f t�; r+r ten__
<br /> j4.j.
<br /> Zia tile event 01nk of Lba�iutruJuttien of saeh eon-wnfurwiwy ha[.u•duusus
<br /> weste; Custmner agrees that it will ha respuusible fur all ,.mals and
<br /> remediation exPensas related to or arising from the proper management
<br /> and disposal of the non-cunfermrin0 waste, including the cusL of
<br /> erpl ipnleat Jel ontulo last ion wed suL.ennror .1:........• r
<br />
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