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CSG SK-SSL-BOX-24 Wilmer Garcia Garcia 11/28/17 12:33 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 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMER# RA24640 Rail Terminal Services 75450287 <br /> 1000 E Roth Rd SRVC WEEK: 2017-48 <br /> French Camp CA 95231-0000 SRVC DATE: 11/28/17 <br /> PHONE 209-546-7279 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> RA24640 Rail Terminal Services <br /> 1000 E Roth Rd <br /> French Camp CA 95231-0000 <br /> PHONE 209-546-7279 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 83383 DRUM,55 WASTE O.F. 1.000 80.0000 0.00 80.00 <br /> SERVICE TERM 8 WEEK <br /> 1426863/ <br /> 875460 CNO-NON HAZARDOUS SOLID 5 1.000 262.0000 0.00 262.00 <br /> SERVICE TERM 24 WEEK <br /> # CONTS: 1 TSDF: SJ MANIFEST#: 006286470SKS FORM CD: US SHIP# 224083530 <br /> CNT#: 171114857582 QTY: 200 WT/VOL P PROF# 1426863 SKDOT 8016665 <br /> 8003369 DRUM, 55 GL BLACK STEEL 0 2.000 76.0000 11.78 163.78 <br /> SERVICE TERM 24 WEEK <br /> 1558903/ <br /> 875120 LCCRQ 55GL LP AEROSOLS FO 1.000 416.0000 0.00 416.00 <br /> SERVICE TERM 12 WEEK <br /> # CONTS: 1 TSDF: WI MANIFEST#: 66657 FORM CD: BL SHIP# 224083549 <br /> CNT#: 171114857629 QTY: 150 WT/VOL P PROF# 1558903 SKDOT 8077004 <br /> 3383 DRUM,55 GAL FOR O.F. 1.000 10.0000 0.00 10.00 <br /> SERVICE TERM 8 WEEK <br /> 100001 FEE, FUEL SURCHARGE 1.000 11.8200 0.92 12.74 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 1.000 0.0000 0.00 0.00 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 855.8200 12.70 944.52 <br /> TOTAL CHARGE 944.52 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 944.52 <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT 944.52 <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 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 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 />