Laserfiche WebLink
CSG 59-SSL-BOX-23 Raymond Gomez 11/15/18 09:04 PAGE 1 <br /> F Safety-Kleen Systems, Inc, <br /> 2000 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-K1en) <br /> 2005453011 <br /> REFERENCE NRR. <br /> CU5TOh1ER# CA37091 Cal-Trans Shop'10- Lodi 78421142-1805691193 <br /> 845 E Pine St SRUC WEEK: 2018-46 <br /> Lodi CA 05240-3108 SRVC DATE: 11/15/18 <br /> PHONE 209-333-6953 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> CA39570 CAL Trolls - Dist 30 <br /> Po Box 1632 <br /> Stockton CA 95201-3038 <br /> PHONE 209-948-7815 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TDTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 26730 MODEL 26 W/STAND 6365 1.000 50,0000 3.88 53.88 <br /> S/N 11013427 TAG 000011125911013427 CLEAN 0.250 SPENT 0.000 <br /> SERVICE TERM 12 WEEK SCANNED YES <br /> 0 CONTS: 1 75DF: SCA MANIFEST#: 006686985SKS FORM CO! US SHIP# 226932153 <br /> CNT#1 181108709519 QTY: 5 VT/VOL G PROF#156013 SKOOT 14626 <br /> 99837 MODEL 94 W/2387 &6365 1.000 88.0000 8.62 99.82 <br /> S/N 04120160 TAG 70000000%X90210003 CLEAN 2.000 SPENT 0.800 <br /> SERVICE TERM 22 WEEK SCANNED YES <br /> 4 CON7S! 1 TSOF: SCA MANIFEST#: 006686985585 FORM CD: US SHIP#226932153 <br /> CNT#: 181106772729 QTY: 20 WT/VOL G PROF# 156023 SRDOT 14941 <br /> ________________ <br /> TOTAL SERVICE/PRODUCTS 138.0000 10.70 146.70 <br /> TOTAL CHARGE 148.70 <br /> CREOI75 0.00 <br /> ........... <br /> IDTAL DUE ---- 148.70 <br /> UNPAID BALANCE THIS RECEIPT 146.70 <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 /> EmergOucY closing of lid unobstructed? Yes <br /> MRChine Properly grounded? Yes <br /> Local Phone No. Sticker Affixed to Machine Yes <br /> spent solvent meets acceptance criteria? Yes -.. <br /> GENERATOR STATUS <br /> 220-2200 lbs/montll <br /> Customer certifies that (i) tilt abovo-named materials are properly <br /> classified, packaged, marked and labeled, and are in proper condition <br /> ' fur 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 /> j generating the waste/material, and (i44) the above referenced <br /> Generator Status is correct. Cnstomar Rupees to pay the above charges <br /> and to be bound by the terms and conditions (1) set forth in (a) the <br /> General Terns and Conditions provided separately to Cnstomea 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. If Customer failsto make payment when due, an <br /> amount equal to the lesser of Gi) L.S% par month (18%per annum) or <br /> Hi) the max'mum nt 17 w d b 7 ill h dd d to <br /> 17 'd <br />