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if high risk source, rep. certifies that load specific PCB & silicon
<br /> testing have been completed prior to pumping this load.
<br /> C5G sK-SSL-UMO-01 Joseph R Lima ]r 08/29/i8 12:46 PAGE 1 GENERA-MR STATUS
<br /> CESQG: Vehicle
<br /> Customer certifies that (i) the above-named materials are properly
<br /> Safety-K1 e e n Systems , Inc . classified, packaged, marked and Tabeled, and are in proper condition
<br /> 2600 N Central Expy, Suite 200 for transportation according to the applicable regulations YF the
<br /> Richardson. 7X 75080 Department of Transportation (ii) no material change has occurred
<br /> CORPORATE: 800-669-5740
<br /> either in the characteristics of the waste/material or in the process
<br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) generating the waste/material, and (iii) the above referenced
<br /> 2095451011 Generator Status is correct. Customer agrees to pay the above charges
<br /> REFERENCE NBR. and to be bound by the terms and conditions (1) set forth in (a) the
<br /> CUSTOMER# C079848 Ingredion Inc 77696053-1804203751 General Terms and Conditions provided separately to Customer or (b)
<br /> 1021 Industrial Or SRVC WEEK: 2016-33 any SK agreement signed by Customer and SK, and (2) incorporated
<br /> Stockton CA 95206-3928 SRVC DATE: 08/29/1: herein by reference. Unless otherwise indicated in the payment
<br /> received section, SK is authorized to charge Customer's account for
<br /> PHONE 209-54/-8233 this transaction. If Customer fails to make payment when due, an
<br /> BILL TO CUSTOMER# BILL TO ADDRESS: amount equal to the lesser of (i) 1.S46 per month (18% per annuls) or
<br /> C080437 Ingredion Inc (ii) the maximum amount allowed b law, will be added to all unpaid
<br /> 510 S. Cincinnati Ave y p
<br /> amounts outstanding. Customer certifies that the individual signing
<br /> Tulsa oK 74119-0000 this Service Acknowledgement is duly authorized to sign and bind
<br /> PHONE 209-S47-8257 TAX EXEMPT# Customer. Customer acknowledges that it is responsible for maintaining
<br /> PURCHASE tlRDER# 8-29-18 its Generator Status and obtaining an EPA ID number if required by
<br /> PRODUCT/SERVICES applicable law. The following provision is applicable to
<br /> TOTAL Safety-Kleen's parts cleaner and paint gun cleaner services: Customer
<br /> SERVICE/ agrees that it will not introduce any substance into the solvent or
<br /> PRODUCT QTY PRICE TRX CHARGE aqueous cleaning solution, includingy
<br /> without limitation an hazardous
<br /> SERVICE TERM 66636 .1SE0 DIE TEM 12 WEEK AUT014gTI 255.00000 0.2900 0.00 73.91 waste or hazardous waste cunstituent, except to the extent such
<br /> HALOGEN / CLOR-O-TELT TEST RESULT PASS: PPM < 1000 introduction is incidental to the normal use of the machine. Customer
<br /> I0256 FEE, OIL SERVICE/STOP NON 1.000 215.0000 0.00 215.00 further agrees that it will not clean parts/paint gt;ns that have been
<br /> Contaminated with or otherwise introduce polychlorinated biphenyls
<br /> SERVICE TERM 12 WEEK ____________ 03CB's), herbicides, pesticides, dioxins or listed hazardous waste
<br /> into the solvent or aqueous cleaning solution. Safet Kleen has the
<br /> TOTAL SERVICE/PRODUCTS 215.2900 0.00 288. Y-
<br /> capacity and is permitted to accept, store, and/or reclaim the spent
<br /> TOTAL CHARGE 285.95 Parts, washer solvent; paint thinners, solvents and paints generated by
<br /> CREDITS OOU customer; or dry cleaning filter cartridges, powder, and still
<br /> --------- ,
<br /> ___ residues containing perchloroethylene, petroleum naphtha, or
<br /> TOTAL DUE 288.95 triflurotrichloroethane dry cleaning solvents. Customer agrees that it
<br /> is responsible for properly classifying its waste streams as Used Oil
<br /> ^'�-- --" or Nonhazardous Waste in accordance with the provision of 40 CPR
<br /> 262.11 and applicable state laws. Customer agrees that it will not
<br /> UNPAID BALANCE THIS RECEIPT 288,95 introduce any nun-conforming substance into the SK Property,
<br /> including, without limitation, any hazardous waste or hazardous waste
<br /> constituent,(i.e., polychlorinated biphenyls ("PCBs"), herbicides,
<br /> pesticides, dioxins, or listed hazardous wastes) except to the extent
<br /> such introduction is incidental to the normal use of the SK property.
<br /> In the event of the introduction of such non-conforming hazardous
<br /> waste, Customer agrees that it will be responsible for all costs and
<br /> remediation expenses related to or arising from the proper management
<br /> and disposal of the non-conforming waste, including the cost of
<br /> equipment decontamination and subsequent disposal. Final invoicing
<br /> will be based on the actual services provided, which may include
<br /> additional charges for off specification waste and surcharges. Final
<br /> invoice amount may be more than the amount listed on the printed
<br /> receipt. If any legal action is commenced because of an alleged
<br /> dispute, breach, default or misrepresentation, the Customer also
<br /> agrees that the prevailing party will be entitled to recover
<br /> reasonable attorney's fees and costs associated with the
<br /> non-conforming contamination event. Safety-Klaen's failure to screen
<br /> Customer's material or take a retain sample, in no way constitutes a
<br /> waiver of Customer's Obligation to properly classify its materials.
<br /> Safety-Kleen relies on Customer's representations and Customer is
<br /> responsible for informing Safety-Kleen of any process changes that may
<br /> alter the characteristics of the materials provided. IN THE EVENT OF
<br /> AN EMERGENCY CALL v*24-HR NUMBER** 1-860--468-1760 (Safety-Kleen) A
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