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CSG SK-9SL-BOX-23 <br />Raymond Camez 06/26/18 09;42 PAGE 1 g <br />Safety-K7een Systems, Inc, t <br />.;04 N Central Expy, Suite 200 <br />Richardson, TK 7SOSO <br />CORPORATE: 800-669-5740 f <br />24 HR EMERGENCY: 800-468-1760 (Safety -Klee") <br />2095451011 <br />CUSTOMER# 5743054 Stockton Delta Resort REFERENCE NOR. <br />14900 W Highway 32 77204$42-1803125840 't <br />Lodi CA 95242-4000 SRVC WEEK: 2018-2b <br />PHONE 209-283-1589 SRVC DATE: 46/26/18 <br />BILL TO CUSTOMER# BILL To ADDRESS: <br />Stockton Delta Resort y <br />14900 W Highway 12 <br />Lodi CA 95242.0000 <br />PURCHASE ORDER# PHONE 209-283-1589 <br />PRODUCT/SERVICES TA's EXEMAT# 1 <br />SERVICE/ <br />PRODUCT QTY UNIT PRICE TOTAL <br />1667001/ TAX CHARGE <br />875460 CNO-NQN HAZARDOUS SOLID 5 2.000 <br /># CONTS: 2 TSDF: 5) MANIFEST#: 011559094fle FORM COOOUS SHIP# 0.00 800 I <br />CNT#: 1806I9099540 QTY: 150 22578129 <br />, WT/VOL P PROF# 1667003SKDO <br />33 T 8342012 € <br />CNT#: 180619099S39 QTV- ISO WT/VDL p PROF# 1667009 SKO4T 8342012 j <br />80069 DRUM, 55 GL BLACK STEEL 0 <br />SERVICE TERM 24 WEEK 2.000 76.0000 11.78 163.78 <br />100030 RECOVERY FEE 1.000 i <br />_ 54.0840 4.19 58.27 <br />i <br />--------------- <br />" TOTAL SERVICE/PRODUCTS 392.0804----------^--------^- <br />15.97 746.Q5 <br />TOTAL CHARGE 746,05 <br />CREDITS 0.00 <br />TOTAL DUE - -746.05 <br />UNPAID BALANCE THIS RECEIPT <br />746.05 <br />'k 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'candition <br />for transPortatia" according to the applicable regulations of the <br />Department of Transportation (ii) no material change has occurred <br />either in rhe characteristics of the waste/material or in the process <br />generat'"" 'Ire waste/material, and Ciii) the above referenced <br />Generar. -atus is correct. Customer agrees to pay the above charges <br />and t" "' pound by the terms and conditions forth in Cal the <br />(1) set <br />Gene,'::r =erms and Conditions provided separately et Customer or (b) <br />any ,.r. agreement signed by Customer and SK, and (2) incorporated <br />received section, SK <br />here i, by reFerente. Unless otherwise indicated in the payment <br />is authorized to charge Customer's account for <br />this transaction. of Customer +::ils to make payment when due, an <br />amount equal to the lesser of <br />(ii) the maximum am:,=.j 1.5% per month (1856 per annurrd or <br />amounts our-z,n,npaunt a" r. by loo;, will he added all unpaid <br />aid <br />l;. r..�t.,..,. <br />!"-t the individual sinning <br />