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CSG SY Yil VAC 42 John.,Ox... 01/11/31 01 06 rALc 1
<br /> Safety-Kleen Systems, Inc.
<br /> 2400 N Central It pap,Suite 100
<br /> Richardson, TY 75080
<br /> COOPOIATC 800 441 5780
<br /> 24 NO TN[R6EMCY:800.460 1)00(Son.....err)
<br /> 1095
<br /> 60SAll. REFEREACC Np`
<br /> NSIORGI 7II0I78 7-11 Materials 80y(yN,46(CY p2016p7
<br /> 1730 St•g•wach Or SDI,(DATE.07/tl/16
<br /> Lndtsp CA 6S71S-0000
<br /> PHONE 206-011-1281
<br /> BILLTO CUSTOMER/ BILL 10 ADOAM
<br /> 71 L0170 7-Il Material.
<br /> 2781 sng.oa.A Dr
<br /> Sbckl•n CA 65715-0000
<br /> PMOIAS[gIDtR1 PMONE 106-Is1-1201 TAA CREW"
<br /> PRODUCT/SERVICES TOTAL
<br /> StsvICE/
<br /> Mar1CT QTY UNIT PRICE TO CT,MGL
<br /> IN4754/ 111.00
<br /> 475121 LCll1O laSO
<br /> L LP AEROLS FO 1.000 311.0000
<br /> CONTS: 1 TWV SJ MANIFESTS: 24446 FORM CO.RL SM1P/52 T1NS0180
<br /> CNTO: IMZGZNISZ On: 180 VTA'OL P p110F0 IN47S4 0 DD 24.80
<br /> 100070 OECWEHY FEC I.O00 24.8000 p.00 10.00
<br /> 100045 [-Moih.t Fee 1.000 10.0000 -._.. ...
<br /> TOTAL SERVICE/PRCDUE-M .-_--I"moo .0.00 146.14
<br /> TOTAL CHARGE 180•M
<br /> CIEDI7S 0.80
<br /> .......746.14
<br /> TOTAL WF
<br /> UNPAID PALAM:r THIS RECEIPT 146.96
<br /> �i TOR STATUS
<br /> O-a2a 0-710 lbs/month
<br /> Customer certifies that(;)the Jove named materials are properly
<br /> classified,P•ckeged.eask.d and labeled,and are in proper condition
<br /> fee transportation according to the applicable regulations of the
<br /> D: —.t of Transportation(ii)no nrte...I these.h *cc,,;*,
<br /> u red
<br /> eitAtr in the cheracnritt ic+of the.ute/material-I-n theprec...
<br /> bene nl;N the.46te/matarial, and(iii)the esp.rNenncW
<br /> Geneeatte Stara i+correct.Cuatrar Nreef t•pay tMo above ch•rg•s
<br /> Rod to be based by the toms and conditions(1)set forth in W the
<br /> General Terme and Condition.provided separately to Cost—'or W
<br /> but SA Nrerne.t signed by Co.,—,and SA,yd(2) lncoryannd
<br /> herein b,reference. unless•therwice lndiceIs in He pay ant
<br /> tce/wed section,SY is euthori.N a chary.Customer's account for
<br /> this trenuct ion. if[wtomor fails to make esMant cion Ire. an
<br /> u....ual to the lef•er•f(i)I.SR par we CIN per annum)or
<br /> the nrximun amount allexel by law,will b•added n all unpaid
<br /> uses o.t.t and ing.Customer cert ifief tA.t tMe iIdiv;du•1 sign int
<br /> this Service Acknooledgement is duly as[h•r;gd to sign:. bind
<br /> Customer.Customer.ckna.leJgee it:.,it is resp...ills for mai.taininf
<br /> it.Generator Status and obtaining ap EPA unre,if required by
<br /> applicable 1•e. The folloxina Pnvition is yPl icable to
<br /> L.fetY-Aleen's parts cleaner.nab p.int gun cleaner cervices: textarr
<br /> Nre+that it till out introduce any+ubatuce 'eL au eel vent
<br /> .4.....clean ins+slut io., including A1h2 lim8ttion an,haardeuf
<br /> to or h.xardou+cute con ituent, a cert to the.tent so
<br /> introWct ion is nciJennlote Me nomrl use s/tAe m.china.Crftomer
<br /> further sprees that it rill not clean porn/paint Ounf that have Yeen
<br /> astamineteJ sith a Otho roue introduce....chlorinated ill:""
<br /> Do'q, herbicides.pesticides, dioxins or listed huardeu+.uta
<br /> into the•elv<nt ar Nuesus cloy in0 solution.Safety-Ales.hes the
<br /> cyst itY and is permittrd n•cqt, sten, yd/•r'•claim tM•pent
<br /> parts...her xe hent: paint thinners, ..ivntf and paint+a...rated b,
<br /> customer;or Ir,cleaning filter cvnidges,p•.der,and still
<br /> usiduq c•ntein ins PerchleroothYlene,Petreleun eyhthe, o
<br /> tr illur•tr ichloroethans dry cleaning a•lveets.Cu•teyr or,,,that it
<br /> n reaPns iYle for pry.rly clus•1fYia,its waste It—u used ail
<br /> e Nonha•er/ous rote in• ardente.it6 the proNsien tf 40 Cm
<br /> 262.11 and applicable seta los. Cuftrrr ynes tut it.ill net
<br /> ietrsducs apf ne-6nfo ming substance into the SD Renault,,
<br /> including.silk eutcl imitation,any h•x.edwa wn er hazardous.ass
<br /> nftituent.(i.e.,polychlorinated biphenyl.(a PC. herbicides
<br /> ass,cides, dioxin., or listed h..ardeus.'utas)ucpt to the.tent
<br /> ucA intraduct ion i cil....I to then mol not of the LA proper tY.
<br /> In the a •f the int.duct ion of ouch n oeformiy hazardous
<br /> uta.Customer uproot tut it.ill be'organs M.for all 1.—and
<br /> radiation etp.....related to s ins from the pry'manapenrnt
<br /> And disposal of the n -asfarmira sate, including the ceft of
<br /> Nu;pment denntrnin•t inn yd fubqu.nt diyeo.l.H..1 i.0
<br /> rill be based on the actual f es provided,shi,h may include
<br /> aJJitional
<br /> Cher..ftr off•p«fiction s..c-d s.charges. Final
<br /> iaveice ant may be more than the taunt listed oe the printed
<br /> rural at.II any legal action is cane nd YtcasfI H an alleged
<br /> dispute, breach.Befoul er mifnpresent.t ion, the Cu•tmer.1+s
<br /> N reel that the prev.iliq party.ill Oe entitled to re r
<br /> enable atnrney's fees and c•tn As iated with th:1.
<br /> un-conforming centaninaties event.Safety-Ylees'f failure to
<br /> Cestemer's material or take•retain+apple, , way c 31stinteaea
<br /> rNver of Customer's tblif.ti•n to araparlY classify it.materials.
<br /> L}•tY-,leen relies•n[uatrar'a ryeeaasctiasa and Cox—i•
<br /> r+pons ible nr inRrmine S.fetY-BIten of apy process there.•that qy
<br /> alter Me characterist its of the arterials provided.IN THE EVENT OF
<br /> A11 EMEROENCy CALL"24-MR NUMBER"1-000-460-1760 Rafety_eleen)A
<br /> viable r very fes that fluctuates with the 00E national aver Ne
<br /> I price j.,be yplid b yasr inoxic.Far neinhmrtion
<br /> Ng.rHnp o ve Y fee c.lculatlon Phos M tare
<br /> http://aafeil-Ylten.cam/
<br /> users'-service/en arntal-fees/n ovary-fNf,Please net.
<br /> manifest fees appl,cable to thio order pry apt be included in the
<br /> total be-And sill be included is the final i_,C.n xe.d;l card
<br /> atatmnt.RECEIPT ONLY-TICIS IS NOT AN 7NWICE
<br /> — 1
<br /> Si�eNe
<br /> CUSTOMER/GENERATOR: br,ce fan
<br /> zt)
<br /> TRANSPORTIO: Jahn.)Oxen.
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