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RECEIVED <br /> SEP 3 0 2016 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-666-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleeo) <br /> 2095451011 <br /> REFERENCE NBR. <br /> Rfe ST29808 Stockton Rubber Mfg Co Inc 66825080 <br /> 502' N Flood Rd SM WEEK: 2015-21 <br /> Linden CA 95236-9455 SRVC DATE: OS/22/15 10:25 <br /> PHONE 209-887-1172 <br /> 1 CUSTOMER* BILL TO ADORESSs <br /> 3 Stockton Rubber Mfg Co Inc ' <br /> 5023 N Flood Rd <br /> Linden CA 95236-9455 <br /> PHONE 209-887-1172 <br /> iE ORDER0 TAX EX&•1PTN <br /> PRODUCT/SERVICES <br /> ICE/ TOTAL <br /> JCT QTY UN.[T PRICE TAX CHARGE <br /> COBS SEC tt,CLEAR u1010E 1.000 $14.8400 0.09 314.64 <br /> S/N 13053S34 CLEAN 1.000 SPENT 0.000 <br /> SERVICE TERM 8 WEEK <br /> DRUM, 55 GL BLACK STEEL 0 1.000 0.0000 0.00 0.00 <br /> SERVICE TERM 24 WEEK <br /> CAUSE CODE VoidHeaderAndl.ine -SEIMCF NOT NEEDED <br /> Of <br /> CNO-NUN HAZARWUS• SOLID 5 1.000 0.0002 0.00 0.00 <br /> SERVICE TERM 8 WEEK <br /> CAUSE CODE VaidHeaderAndLine -SERVICE NOT NEEDED <br /> ALLIED MISC 1.000 0.0000 0.0o 0100 <br /> SERVICE TERM 24 WEEK <br /> CAUSE CODE VoidHeaderAndLine -SERVIC NOT NEEDED <br /> 9 DRUM, SS Gt. 8f ACK ZIEEt. O 1.000 0-M90 n O0. 0400 <br /> SERVICE TERM 12 WEEK <br /> CAUSE CODE VOidHead+rAndl-ine -SFRV.ICF NOT NEEDED <br /> FEE, FUEL SURCHARGE 1.000 21.8200 0.00 11.82 <br /> T01-AL SEWICE/PROUIICTS 326.6600 O.OD !16.66 <br /> TOTAL CHARGE 326.66 <br /> CREDITS 0.Do <br /> TOTAL DUE _- - 326.56 <br /> UNPAID BALANCE 'MI5 RECEIPT 326.56 <br /> Gun Imen pruprrly gr,wndvA In pr•ulw l against clat*tr <br /> icity?Yes <br /> exhaust g= piping rrum this Gun Clamler vented dletctly <br /> r•s yr is it vented inty (vr lvcnted inbAtIr) the paint spray <br /> Yes <br /> e clean and good condition?Yes <br /> ssombly Condition Yes <br /> in place and legible?Yes <br /> e link installed? Yes <br /> •i ocy closing of lid unobstructed?Yes <br /> e properly grounded? Yes <br /> shone No. Sticker Affixed to Machine Yes <br /> selvtnt'leets aecePtauce criteria?Yes <br /> I <br /> TO STATUS <br /> lhs/lsonth <br /> • ., I �,, :rr!,r:-, 1..t. !i� !6s r!......_,-arts •: er:.l. _,• l.r._.t r.qy .. <br /> ::xrkn¢ =014_led. ra:ofzt <br /> e._..ai!:... <br /> arlapvrlal.ivrr a,.avrding to the applisableregulal.6lo, or L6e <br /> tlwitt ..r'r.- .-•:rtx!ivn ..i:A CPU l:•:•:!L..i.l .1:.1..x- I.w ..........1 <br /> in the r.haracterislics or the aaa Le/n,dtur;Al yr in the pru'e» <br /> Ling the waste/malarial. Custwtter agrees to pay the above <br /> s will In In, Inmud by Il+r Iran% and 1u-dil Irmo (1) ire rarlh .n <br /> e General Terms and Condition* provided separately to Customer <br /> any SK qy.-repent siurted b;Coxt,_m,wr And U, and (2) <br /> arwl r.l hrrr;n 4y r•r Trr+-n.:y. 11..1r.. olbrr..-:sr Ind n..trJ :n Ih+- <br /> t rrr.r ivrd waif imp, CK is auf l....•ii,-d *n rAaryr Cl,s hrnrr•s <br /> f rnr Lb:� tr....*..t iuo fl+.Jm rr1 iriTs fhAl 1 <br /> h,! iml:V ilb„rl <br /> V this Service ALknueledgelnenl is duly auLlnuriaed to sign and <br /> uf.Loear. The rullewirlg Previsiwr is dppllaable to Sarety-K111=11% <br /> and uaint -on cleaner services: CasLwuer agrees that it <br />