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CSG SK-SSL-UM0-Q1 Joseph R Lima Jr 09/21/18 08:55 PAGE I <br />Safety-Kleen Systems, <br />Inc, <br />2600 N Central Expy, Suite 200 <br />Richardson, TX 75OSO <br />CORPORATE: 800-069-5740 <br />29 NR EMERGENCY: 800-468-1760 {Safety-Kieen) <br />2495451411 <br />CUSTOMER# ST42948 Stockton Delta Resort, !LC <br />REFERENCE NBR. <br />778671 4536487 <br />14900 W Highway 12 <br />Lodi <br />SRVC WEEEK:EK: 2018-36 <br />CA 95242-0000 <br />SRVs DATE: 09!21!18 <br />BILL TO CUSTOMER# BILL TO PHONE09-283-IS89 <br />A13SA32681 <br />County of San Joaquin DPW/Solid Waste <br />I810 E Hazelton Ave <br />Stockton CA 95205-6232 <br />PURCHASE ORDER# 9-21-18 PHONE 909-947-9363 <br />PRODUCT/SERVICES <br />T' ExEMPT# <br />SERVICE/ <br />PRODUCT <br />ICE <br />10256GE <br />FEE. OIL SERVICE/SJUP NON g <br />TOTAL <br />T <br />1.000IT P145.0000 <br />SERVICE TERM 8 WEEK <br />0.00CH�145.00 <br />56636 USED OIL RECYCLE AUTUMOTI 110.000 0.4900 <br />SERVICE TERM 8 WEEK <br />0.00 53,90 <br />HALOGEN / CLOR-D-TECT TEST RESULT PASS: FPM < 1000 <br />100030 <br />RECOVERY FEE 1.000 0.0000 <br />0.00 0.00 <br />TOTAL SERVICE/pRODUCTS 145.4900 <br />0.00 ^-198.90 <br />TOTAL CHARGE 198.90 <br />CREDITS <br />0.00 <br />TOTAL DUE <br />198.90 <br />r.e�..__ao <br />UNPAID BALANCE THIS RECEIPT 198.40 <br />mama <br />If high risk source, rep, certifies that load specific PCB & Silicon <br />testing have been completed prior to pumping this load. <br />GENERATOR STATUS <br />CESgG: Vehicle <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/mate.rial 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 />day 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 mouth (18% per annum) or <br />(ii) the maximum amount allowed by Taw. 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 />Safety-Kleen's parts cleaner and paint gun cleaner services: Customer <br />agrees that it will not introduce any substance into the solvent or <br />Aqueous <br />cleaning solution, including without limitation any hazardaus <br />waste or hazardous waste constituent, except to the extent such <br />