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CSG SV. 06/07/18 13:08 PAGE <br /> Safe 11 Systems , Inc . <br /> al Expy, Suite 200 <br /> TX 75080 <br /> .ATE: 800-669-5740 <br /> 24 HR EMENGLK-1: 800-468-1760 (Safety-Hleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMER# 189793 18 Hunt - Stoca 77079774-1802844359 <br /> 2660 Loomis Rd SRVC WEEK: 2018-23 <br /> Stockton CA 95205-0000 SRVC DATE: 06107/IB <br /> PHONE 209-235-1365 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> 189788 20 Hunt <br /> 70S B North Bl oamington <br /> Lowell AN 72745-0000 <br /> PHONE 479-659-8505 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICr TOTAL <br /> PRODUc. QTY UNIT PRICE TAX CHARGE <br /> 66667 Vacuum LIQUID UNON-PQUAL) 420.000 1.2500 0.00 525.00 <br /> SLRVICE TERM 24 WEEK <br /> HALOGEN / CLOR-D-TELT TEST RESULT PASS: PPM s 1000 <br /> VAC PH TEST: 8 <br /> 66677 VACUUM SOLID O30N-PQUAL) 980.000 1.7500 0.00 1715.00 <br /> SERVICE TERM 24 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPM s 1000 <br /> VAC PH TEST: e <br /> #CONTS: 1 TSDF: EVG MANIFEST#: 79774 FORM CD: BL SHIP# 225675798 <br /> CNT#: 18060786790S QTY: 1400 Wf/VOL P PROFS 156097 SKDOT 3299 <br /> 10967 VAC SERVICE FEE AUTOMOTIV 1.000 0.0000 0.00 0.00 <br /> 821 DEGREASER, HEAVY DUTY 5 G 3.000 51.0000 13.77 166.77 <br /> SERVICE TERM 24 WEEK <br /> 10134 TECHNICAL LABOR CHARGE 6.000 96.0000 0.00 576.00 <br /> SERVICE TERM 24 WEEK <br /> 10906 VAC SVS SERVICEFEE 5 1.000 520.0000 0.00 520.00 <br /> 10913 VAC TRUCK WASH 1.000 300.0000 0.00 300.00 <br /> 10924 FEE, VAC KLEEN DRAIN SRV 3.000 140.0000 0.00 420.00 <br /> 82118 HALOGENS TEST 1.000 120.0000 0.00 120.00 <br /> 109]] FEE, VAC 70% SOLIDS 1400.000 0.0000 0.00 0.00 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 1230.0000 13.77 4342.77 <br /> TOTAL CHARGE 4342.77 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 438.77 <br /> UNPAID BALANCE THIS RECEIPT 4342.]] <br /> Per BOG M420-001 the halogen detecting instrument has been <br /> zeroed and validated. <br /> GENERATOR STATUS <br /> CESQG: 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/material or in the process <br /> generating the waste/material, and (iii) the have referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to he bound by the term 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 mmrth (18% per annum) or <br /> 60rhr - p11- . :J 1 ..11 u <br />