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TSG SK-SSL-VAC-42 Benjamin 0 Taylor 01/10/18 13:05 PAGE 1 <br /> Safety-Kleen Systems , Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 NR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> CUSTOMER* 389793 38 Hunt - Stoca REFERENCE <br /> )5813331EEK: 219996% <br /> 9 <br /> 2660 Loomis Rd SRVC WEEK: 2018-3 <br /> Stockton CA 95205-0000 SHVC DATE: 01/10/18 <br /> PHONE 209-235-1365 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> 389788 38 Hunt <br /> 705 B North Bloomington <br /> Lowell AR 72745-000 <br /> PHONE 479-659-8505 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> SERVICE/ PRODUCT/SERVICES <br /> PRODUCT MIT PR_CE TOTAL <br /> GE <br /> 66667 VACUUM LIQUID UION-PQUAL) 455.000 1.2600 T 0.00AX 573.30 <br /> SERVICE TERM 24 WEEK <br /> HALOGEN / CLOR-D-TELT TEST RESULT PASS: PPM < 1000 <br /> VAC PH TEST: 8 <br /> # CONTS: I TSOF: FJG MANIFEST#: 13331 FORM CO: BE SHIP# 224439916 <br /> CNT#: 1801089L7149 QTY: 1300 WT/VOL G PROF# 156097 SKDOT 3299 <br /> 66677 VACUUM SOLID (NON-PQUAL) 845.000 1.7500 0.00 1478.75 <br /> SERVICE TERM 24 WEEK <br /> HALOGEN / CLOR-D-TELT TEST RESULT PASS: PPM < 1000 <br /> VAC PH TEST: 8 <br /> # CONTS: 1 TSOF: EVG MANIFEST#: 13331 FORM CO: HE SHIP# 224439916 <br /> CNT#: 180109171SO QTY: 1300 9IvaL G PROF# 156097 SKDDT 3299 <br /> 10967 VAC SERVIC9 FEE AUTOMOTIV 1.00 0.000 0.00 0.00 <br /> 10134 TECHNICAL -ABOR CHARGE 4.000 96.0000 0.00 384.00 <br /> SERVICE T-xRM 24 WEEK <br /> 10913 VAC TRUCK NASH 1.000 300.0000 0.00 300.00 <br /> 10924 FEE, VAC K-EEN DRAIN SRV 3.00 140.0000 0.00 420.00 <br /> 82118 HALOGENS TEST 1.000 120.0000 0.00 320.00 <br /> 10977 FEE. VAC 71% SOLIDS 1300.00 0.0000 0.00 0.00 <br /> 10904 VAC SVS SERVICEFEE 4 1.000 347.0000 0.00 347.00 <br /> ----------------------------------------- <br /> TOTAL SEIMCE/PRODUCTS 1006/010 0.0 3623.05 <br /> TOTAL CHANGE 3623.05 <br /> CREDITS 0.00 <br /> TOTAL DUE 3623.05 <br /> UNPAID BALANC` THIS RECEIPT 3623.05 <br /> Per BOG M420-001 the halogen detecting instrument has been <br /> zeroed and validated. <br /> GENERATOR SLAMS <br /> CESQG: Vehicle <br /> Customer certifies ttat (i) the above-named materials are Properly <br /> classified. packaged. marked and labeled. and are in Proper condition <br /> for transportation .'cording to the applicable regulations of the <br /> Department of Tra.Sp,rtati.P My 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 :orrect. Customer agrees to pay the above [herpes <br /> and to he bound by the terms and conditions (D set forth in <br /> General Terms and Cotditions gravid<d separately to Customer or(4) the <br /> any SK agreement sip ted by [--tomer and SK, and 2) incorporated(b) <br /> herein by reference. Unless otherwise indicated in the <br /> received section. SK is authorized payment <br /> to charge Custume"s account for <br /> this transaction. If Customer fails to make <br /> amount equal to the lesser of payment when due. an <br /> (i) fper month (1896 per annum) or <br /> (ii) the maximum .,at allowed by law law, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the ind ividua <br />