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CSG SK -SSL -BOX- 21 Brandon J Gaither 12/11/19 11 : 13 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 NOR . <br /> CUSTOMER# SK08510 SKS 81824811 -1906492189 <br /> 18832 Mello Rd SRVC WEEK : 201940 <br /> Ripon CA 953664601 SRVC DATE : 12/11/19 <br /> PHONE 2094994095 <br /> BILL TO CUSTOMER# SKS <br /> TO ADDRESS : <br /> SK08S10 <br /> 18832 Mello Rd <br /> Ripon CA 953664601 <br /> PHONE 209 -599 - 4095 TAX EXEMPT# <br /> PURCHASE ORDER# PRODUCT /SERVICES <br /> TOTAL <br /> SERVICE/ QTY UNIT PRICE TAX CHARGE <br /> PRODUCT <br /> 1939990/ <br /> 875000 F61 - LQD FOR FUEL 556E 2 . 000 255 . 0000 0 . 00 510 . 00 <br /> SERVICE TERM 24 WEEK <br /> # CONTS : 2 TSDF : Sl MANIFEST# : 007276679SKS FORM CO ; US SNZP# 230149090 <br /> CNT# : 191205387004 QTY : 350 WT/VOL P PROF# 1939990 SKDOT 8752183 <br /> CNT# : 191205387005 QTY : 22S Wt'/VOL P PROF# 1939990 SKD014 8752183 <br /> 100030 RECOVERY FEE 1 . 000 43 . 3500 0 . 00 43 . 35 <br /> jC <br /> 100065 E-Manifest fee 14000 20 . 0000 0 . 00 20 . 00 <br /> TOTAL SERVICE/PRODUCTS 318 . 3500 0 . 00 573 . 35 <br /> TOTAL CHARGE 570 . 00 <br /> CREDITS <br /> TOTAL DUE 573 . 35 <br /> UNPAID BALANCE THIS RECEIPT 573 . 35 <br /> GENERATOR STATUS <br /> 220 -2200 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 tine 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 transmake payment when due , an <br /> action . If Customer fails to <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 outstandings Customer certifies that the individual signing <br /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer . Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law . The following provision is applicable to <br /> Safety - Kleen ' s parts cleaner and paint gun cleaner services : Customer <br /> agrees that it will not introduce any substance into the solvent or <br /> aqueous cleaning solution , including without limitation any hazardous <br /> waste or hazardous waste constituent , except to the extent such <br /> introduction is incidental to the normal use of the machine . Customer <br /> further agrees- that -it -will not clean parts/paint guns that have been <br /> contaminated with or otherwise introduce polychlorinated biphenyls <br /> rornoc% henhir ; dnc . .,,.cticides : " dioxins or listed hazardous waste <br />