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13:05 PACE 1 ` <br /> CSL SR-,SL-VAC-92 Beniemin 0 Taylor 01/10/18 7 <br /> Safety-Kleen Systems , Inc . <br /> 2600 N Central Espy, Suite 200 <br /> Richardson, TX 75080 — \ <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 2760 CSafety-Klee") <br /> 09545301 <br /> REFERENCE SBR. <br /> 75813331-1800119969 <br /> CUSTOMER# 189793 19 Hunt - Staca Spy( WEEK; 2018-3 <br /> 2660 Loomis Rd SHVC DALE: 01/10/18 <br /> Stockton CA 95205-0000 <br /> PHONE 209-235-1365 <br /> BILL TO CUSTOMERS BILL M ADDRESS: <br /> 169788 <br /> ]OS B Nerth Bloomington <br /> Lowell 5-0000 <br /> PHONE94]9 6S9-8505 <br /> TAX EXEMPTS <br /> PURCHASE ORDER# PRODUCT/SERVICES <br /> TOTAL <br /> SERVICE/ qTYUNIT PRICE TAX CHARGE <br /> PRODUCT 1.2600 0.00 573.30 <br /> 66667 VACUUMSERVITEJIDRM UN TERM <br /> 455.DOO <br /> CE_ <br /> HALOGEN / CLOR-D-TELT TEST RESULT PASS: PPM < 1000 <br /> VAC PH TE'iT: 8 FORM CO: BL SNIP# 224434916 <br /> # COSTS: 1 TSDF: FJC MANIFESTS: 13331 <br /> CNTS: 180108917149 QTY: 1300 WT845.000 PROF1.7500 7 O.00 1479.75 <br /> - 66677 VACUUM SOLD (NON-PQUAL) <br /> SERVICE TERM 24 WEEK <br /> HALOGEN / CLOR-D-TELT TEST RESULT PASS: PPM < 1000 <br /> VAC PH TETT: B <br /> # CONT,: 1 TSOFEVC MANIFESTO: 13331 FORM CD: BL SNIP# 224439916 <br /> CNT#: 180108: 917150 QTY: 1300 WADL000 PROF#000097 O.00OOT 3 0900 <br /> 10967 VAC SERVICc FEE AUTDMOTIV 1.4,000 96.0000 0.00 384.00 <br /> ` 10134 TECHNICAL _ABOR CHARGE <br /> SERVICE TcRM 24 WEEK <br /> 1.000 300.0000 0.00 300.00 <br /> 10913 VAC TRUCK SASH <br /> 3.000 <br /> 10924 FEE. VAC K-EEN DRAIN SRV 1 0.00 420.00 <br /> 82118 HALOGENS TEST 1.000 1220.0000 0.00 120.00 <br /> 0.0000 <br /> 0.000 0.0000 0.00 0.00 <br /> 10977 FEE, VAC ])%SOLIDS 130 347.00 <br /> 10904 VAC SVS SEHVICEFEE 4 1.000 347.00-- ---- ------ <br /> TOTAL SEDuTCE/PBODUCTS 1006.0100 0.00 3623.05 <br /> TOTAL CHARGE 3623.05 <br /> 3,00 <br /> CREDITS <br /> _______________ <br /> TOTAL DUE 3623.05 <br /> UNPAID BALANCE THIS RECEIPT 3623.05 <br /> Per BOG M420-001 the halogen detecting instrument has been <br /> zeroed and validated. <br /> GENERATOR STATUS <br /> CESQG: Vehicle <br /> Customer certifies tier (3) the above-named materials are properly <br /> classified. packaaed. marked and laheled, and are in proper condition <br /> far transportation .-carding to the applicable regulations of the <br /> Department of Tra.SP,rtatian (ii) no material change has occurred <br /> either in the characteristics of the waste/materiel or in the process <br /> generating the waste/material, and (iii) the above referenced <br /> Generator Status is -orrect. Customer agrees to pay the above charges <br /> and to be bound by tie tenre and conditions (1) set forth in (a) the <br /> General Terms and Colditions provided separately to Customer or (b) <br /> any SK agreement sigied by Customer and SX. and (2) incorporated <br /> -_rein 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 /> rill the maximus, amomt. allowed by law. will he added to all unpaid <br />