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CSG SK-SSL-UMO-01 Joseph R Lima Jr 01/24/19 08:50 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# EN21729 Energy Systems 79082230 <br /> 7100 Longe St Ste 300 SRVC WEEK: 2019-4 <br /> Stockton CA 95206-3997 SRVC DATE: 01/24/19 <br /> PHONE 209-870-1900 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> EN21729 Energy Systems <br /> 7100 Longe St Ste 300 <br /> Stockton CA 95206-3997 <br /> PHONE 209-870-1900 <br /> PURCHASE ORDER# 9589 TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 66636 USED OIL RECYCLE AUTOMOTI 0.000 0.0000 0.00 0.00 <br /> SERVICE TERM 4 WEEK <br /> CAUSE CODE VoidHeaderAndLine -SERVICE NOT NEEDED <br /> 10256 FEE, OIL SERVICE/STOP NON 1.000 105.0000 0.00 105.00 <br /> SERVICE TERM 4 WEEK <br /> 66636 USED OIL RECYCLE AUTOMOTI 310.000 0.6900 0.00 213.90 <br /> SERVICE TERM 4 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPM < 1000 <br /> 10256 FEE, OIL SERVICE/STOP NON 1.000 0.0000 0.00 0.00 <br /> SERVICE TERM 4 WEEK <br /> CAUSE CODE VoidHeaderAndLine -SERVICE NOT NEEDED <br /> 66665 ANTIFREEZE (NON-PREQUAL) 60.000 0.1500 0.00 9.00 <br /> SERVICE TERM 8 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPM < 1000 <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCTS 105.8400 0.00 327.90 <br /> TOTAL CHARGE 327.90 <br /> CREDITS 0.00 <br /> --------------- <br /> TOTAL DUE 327.90 <br /> --------------- <br /> UNPAID BALANCE THIS RECEIPT 327.90 <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 /> CESQG: Vehicle <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 />