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CSG SK-SSL-BOX-23 Raymond Gomez 12J03JIS 09:41 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Ezpy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMER# IC10836 )C Trucking Inc 78656322 <br /> 1415 W. Anderson St. SRVC WEEK: 2018-49 <br /> Stockton CR #fZ"-0000 SRVC GATE: IZ41119 <br /> PHONE 209-466-3282 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> ICIO836 3C Trucking Inc <br /> 1415 W. Anderson St. <br /> Stockton CA 95206-0000 <br /> PHONE 209-466-3282 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> SERVICE/ <br /> PRODUCT/SERVICES <br /> TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 3637 BOX. 1 YARD 5 WALL CORRUG 2.000 162.0000 29.16 353.16 <br /> 100030 RECOVERY FEE 1.000 29.1600 2.62 31.78 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 191.1600 31.78 384.94 <br /> TOTAL CHARGE 384.94 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 384.94 <br /> UNPAID BALANCE THIS RECEIPT 384.94 <br /> GENERATOR STATUS <br /> 0-220 lbs/month <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 wastelmaterial 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 /> 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 eaual to the lesser f r;% i ea --- ___.� <br />