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CSG SK- SSL-BOX- 23 Raymond Gomez 09 / 20 / 18 08 : 23 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# C0103025Corto Olive Co . 77789406- 1804367532 <br /> 10201 Live Oak Road SRVC WEEK : 2018 - 38 <br /> Stockton CA 95212 - 0000 SRVC DATE : 09 / 20 / 18 <br /> PHONE 209 - 365 - 7177 <br /> BILL TO CUSTOMER# BILL TO ADDRESS : <br /> C0103025 Corto Olive Co . <br /> 10201 Live Oak Road <br /> Stockton CA 95212 - 0000 <br /> PHONE 209 - 365 - 7177 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE / TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 905837 MODEL 90 . 5 W/ 2387 6365 10 1 . 000 257 . 5100 23 . 18 280 . 69 <br /> SIN 15100131 TAG T000000 = 14000892 CLEAN 2 . 50 SPENT 0 . 000 <br /> SERVICE TERM 12 WEEK SCANNED YES '.. <br /> 8003369 DRUM , 55 GL BLACK STEEL 0 2 . 000 85 . 0000 15 . 30 185 . 30 <br /> SERVICE TERM 24 WEEK '.. <br /> 100030 RECOVERY FEE 1 . 000 38 . 4800 3 . 46 41 . 94 <br /> TOTAL SERVICE / PRODUCTS 380 . 9900 41 . 94 507 . 93 <br /> TOTAL CHARGE 507 . 93 <br /> CREDITS 0 . 00 <br /> TOTAL DUE 507 . 93 <br /> UNPAID BALANCE THIS RECEIPT 507 . 93 '.. <br /> Machine clean and good condition ? Yes <br /> Lamp Assembly Condition Yes <br /> Decals in place and legible ? Yes <br /> Fusible link installed ? Yes <br /> Emergency closing of lid unobstructed ? Yes <br /> Machine properly grounded ? Yes <br /> Local Phone No . Sticker Affixed to Machine Yes <br /> Spent solvent meets acceptance criteria ? Yes <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 /> this transaction . I £ Customer fails to make payment when due , an <br /> amount equal to the lesser of ( i ) 1 . 5 % per month ( 18 % per annum ) or <br /> ( ii ) the maximum amount allowed by law , will be added to all unpaid <br /> amounts outstanding . Customer certifies that the individual signing <br /> I <br /> i <br />