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CSG SK -SSL -BOX -23 <br />Raymond Gomez 04/19/17 <br />14:56 PAGE 1 <br />0.00 <br />Safety-Kleen Systems, Inc. <br />2600 N Central Expy, Suite 200 <br />DRUM,55 GAL FOR O.F. <br />1.000 <br />Richardson, TX 75080 <br />0.00 <br />SERVICE TERM 24 WEEK <br />CORPORATE: 800-669-5740 <br />24 <br />HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br />2.000 <br />81.0000 <br />2095451011 <br />SERVICE TERM 24 WEEK <br />REFERENCE NBR. <br />CUSTOMER# T029125 <br />Tower Park Marina <br />73481528 <br />0.00 <br />14900 W Highway 12 SRVC <br />WEEK: 2017-16 <br />209.7600 <br />Lodi CA 95242-9514 SRVC DATE: <br />04/19/17 14:55 <br />PHONE 510-834-4591 <br />BILL TO CUSTOMER# <br />BILL TO ADDRESS: <br />SA32681 <br />County of San Joaquin DPW/Solid Waste <br />1810 E Hazelton Ave <br />Stockton CA 95205-6232 <br />PHONE 909-947-9363 <br />PURCHASE ORDER# <br />TAX EXEMPT# <br />PRODUCT/SERVICES <br />SERVICE/ <br />PRODUCT <br />83383 <br />3383 <br />7207 <br />3230 <br />QTY UNIT PRICE TAX <br />TOTAL <br />CHARGE <br />108.16 <br />DRUM,55 WASTE O.F. <br />1.000 <br />108.1600 <br />0.00 <br />SERVICE TERM 24 WEEK <br />DRUM,55 GAL FOR O.F. <br />1.000 <br />20.6000 <br />0.00 <br />SERVICE TERM 24 WEEK <br />MAT, SINGLE WGT OIL 16" X <br />2.000 <br />81.0000 <br />12.56 <br />SERVICE TERM 24 WEEK <br />TAX HANDLING N/C DRUM DROP 30 <br />1.000 <br />0.0000 <br />0.00 <br />------------------------------- <br />TOTAL SERVICE/PRODUCTS <br />209.7600 <br />12.56 <br />TOTAL CHARGE <br />CREDITS <br />TOTAL DUE <br />UNPAID BALANCE THIS RECEIPT 303.32 <br />GENERATOR STATUS <br />0-220 lbs/month <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 (i) 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 />Page 5 <br />20.60 <br />174.56 <br />0.00 <br />303.32 <br />303.32 <br />0.00 <br />303.32 <br />