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CSG SK-SSL-BOX-23 Raymond Gomez 00/11/19 13:19 PAGE 2 <br /> SHIPPING DOCUMENT <br /> IN THE EVENT OF AN EMERGENCY CALL **24-Hr-Numbersm + ' - <br /> CVSTOML-R#/GENERATOR; F1.1028 Fleenor paper Ce' <br /> 4201 E Fr, <br /> CSG SK-SSL-BOX-23 Raymond Gomez 00/11/19 13;19 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 600-660-5740 <br /> 24 HR EMERGENCY; NO-466-1760 (Safety-Kleen) <br /> 2ODS4S1011 <br /> REFERENCE <br /> CUSTOMER# FL18528 Fleenor Paper Co Inc 61046112-1904763636 <br /> 4201 E Fremont St SRVC WEEK: 2010-37 <br /> Stockton CA PS215-4614 SRVC DATE; 09/11/19 <br /> PHONE 707-2S7-1820 <br /> BILL TO CUSTOMER~ BILL TO ADDRESS; <br /> FLIS491 Fleenor Paper Co <br /> 2225 Harbor Bay Parkway <br /> Alameda CA 94502-0000 <br /> PHONE 200-S32-1949 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 3363 DRUM,SS GAL FOR 0.F. 1.000 010000 0100 0.00 <br /> SERVICE TERM 24 WEEK <br /> CAUSE CODE VoidliesderAndLine -SERVICE NOT NEEDED <br /> 83383 DRUM,SS WASTE O.F. 1.000 308.1500 0.00 106.15 <br /> SERVICE TERM 24 WEEK <br /> 100030 RECOVERY FEE 1.000 15.0000 0.00 15.00 <br /> 1230 TAX HANDLING N/C DRUM DROP 30 1.000 0.0000 0.00 0100 <br /> TOTAL SERVICE/PRODUCT5 123,1500 0.00 123.15 <br /> TOTAL CHARGE 123,15 <br /> CREDITS D.00 <br /> TOTAL DUE 123.15 <br /> UNPAID BALANCE THIS RECEIPT 123.15 <br /> GENERATOR STATUS <br /> 0-220 lba/month <br /> fustamer crrtifies that (i) the uirnve nanwo materials al•e prnpr.rly <br /> f lesslfied, packaged. aurYr.d and labeled, and are in proper fonditinll <br /> For transpurLation accardiny to the applicable regulations of elle• <br /> Department of Trnntiportation (ii) thhh mzteriel rlianye has occurred <br /> either in the chargr.trristict of rile vaste/malerial or in the process <br /> 0eneratint tht paste/material, and (iii) the ahoy referenced <br /> Generator Status is Correct. 0%torm.r agrees to pity thr nlrnVr thargcs <br /> end to be bound by the term and conditionx (t) eel forill in (a) time <br /> Grner•al Terms and Cenditiatus provided separately to Customer or (b) <br /> any SK agratmeat signed by Cuctamer and Sit, amid (2) inforpar•ntcd <br /> herein by referenre. Unless otheivise indicated in the palnhrnt <br /> received section, sK is authorised to charge Custom er's arcaunt fel• <br /> This transaction. Ir Customer Fails to lsafrr trayixrnt ellen due, on <br /> mount equal to the lnsar of (i) I.V% per month ()8%per apnturh) or <br /> (ii) the Mem(qurm aalaunt allot,cd by law, will be added 1.9 all unpaid <br /> ■mounts outstandinq. Casttxner cartifies that the individual signing <br /> shim Service Acincwtadaement ie dilly autlwrictd to •ion end Lind <br /> Chaturnnr. Cusfurnnr acttnan•ledars [hat it is re+pansilrle for maintainiuu <br />