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CSG SK-SSL-UMO-01 Joseph R Lima Ir 10,09/19 11:56 PAGE I <br /> Safety-Kleen Systems , Inc . <br /> 2600 N Central Expy, Suite 200 <br /> Fichardson, TX 75080 <br /> CCRPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Klren) <br /> 2095451011 <br /> REFERENCE NOR. <br /> CUSTOMER# CH32532 Cherokee Freight Lines 81346422 <br /> 5463 Cherokee Rd SRVC WEEK: 2019-41 <br /> Stocktor CA 9S21S-1128 SRVC DATE: 10/09/19 <br /> PHONE 209-931-3573 <br /> BILL TO CUSTOMER# BILL TP AODRESt:" <br /> CH33889 Cherokee Freight Line <br /> 5463 Chsrokee Rd <br /> Stocktor,' CA 95215-1128 <br /> PHONE 800-662-3430 - <br /> PURCHASE ORDER# 65269 TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 66665 ANTITREEZE (JON-PREQUAL) 50.000 0.350[ 0.00 17.50 <br /> SERVICE TERM 12 WEEK <br /> HALOGEN / CLOR-O-TELT TEST RESULT PASS: PPM < 21000 <br /> # CONTS: 1 TSOF: EVG MANIFEST#: 007158521SKS FORM CO: L5 SHIP# 229692754 <br /> CNT#: 191009282249 QTY: SO WT/VOL G PROF# 156130 SKDOT 6S1 <br /> TOTAL SERVICE/PROBUCTS 0.350[ 0.00 17.50 <br /> TOTAL (HARGE 17.50 <br /> CREDITS: 0.00 <br /> a <br /> --------------- <br /> TOTAL EUE 17.50 <br /> --------------- <br /> UNPAID.BALANCE THIS RECEIPT 17.50 <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 /> SQG/LQG: Vehicle <br /> Customer certifies that (i) thx above-named materials are 1:roperly <br /> classified, packaged, marked aid labeled, and are in propel- 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 above referenced <br /> Generator Status is correct. Customer agrees to Pay the abcnre charges <br /> and to be bound by the terms and conditions (1) set forth `n (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 pa;ment <br /> received section, SK is authorized to charge Customer's account for <br /> this transaction. If Customer 'Tails to make payment when due, an <br /> amount equal to the lesser of (i) 1.5% per month (18% per c:nnum) or <br /> (ii) the maximum amount allowed by law, will be added to a'1 unpaid <br /> amounts outstanding. Customer certifies that the individua` signing <br /> this Service Acknowledgement ic; 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-Teen's parts cleaner and paint gun cleaner services: Customer <br /> agrees that it will not introduce any substance into the solvent or <br /> aqueous cleaning solution, incouding without limitation ani hazardous <br /> waste or hazardous waste constituent. except to the extent such <br /> introduction is incidental to the normal use of the machino. Customer <br /> further agrees that it will not: clean parts/paint guns than; have been <br /> contaminated with-or-otherwise introduce nol,rcc.7_r9gw.t a-h'��r_�al�. <br />