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n-SSL-BO%-2`. Raymond Gomez 08/23/18 13:59 PAGE 1 <br /> Safety-Kleen Systems , Inc. <br /> 2600 N Central Ex Py, Suite 200 <br /> Hichardson, 'fX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety elven) <br /> 2095451011 <br /> REFERENCE NOR. <br /> CUSTOMER# CA47958 Cal-Tans Shop 10- Lodi Cws 77689060.1804164989 <br /> 845 E Pine St SRVC WEEK: 2018-34 <br /> ' Lodi CA 95240-3108 SRVC DATE: 08/23/18 <br /> PHONE 209-333.6953 _ <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> CA47769 Caltrans Cws <br /> pa Box 1632 <br /> Stockton CA 95201-3038 <br /> PHONE 209-948-7815 <br /> PURCHASE ORDER# TAX E%EM11PT# ' <br /> PRODUCT/SERVICES <br /> SERVICE/ - TOTAL - <br /> Pfl000Cr QTY UNIT PRICE TAX CHARGE <br /> 40713004/ <br /> 875460 CNO-NON HA2ARBOUS SOLID 5 1.000 140,.0000 0.00 140.00 <br /> SERVICE TERM 12 WEEK <br /> # CONTS: I TSOF: BL MANIFESTO: 011844881fla FORM CO; US SHIP# 226249394 <br /> CNT#: 180815180659 QTY: 150 Wr/vOL P PROF# 40713004 SNOUT 7370310 <br /> 3383 BRUM.55 GAL FOR O.F. 1.000 0.0000 0.00 0.00 <br /> SERVICE TERM 12 WEEK <br /> 83383 owm,55 WASTE O.F. 1.000 45.0000 0.00 45.00 <br /> SERVICE TERM 12 WEEK _ <br /> # CONIS9385 <br /> CNT#: 80815 80605M On: 250 OWTNOL8Pf1aPROF# 156033 FORM CO: US SH P#SHOOT47872676 <br /> 8003369 DRUM, 55 GL BLACK STEEL 0 1.000 0.0000 0,00 0.00 <br /> SERVICE TERM 12 WEEK <br /> 3230 TAX HANDLING N/C DRgl1 DROP 30 1.000 0.0000 0.00 0.00 - <br /> ----------------------------------------- <br /> TOTAL SERVICE/PKODUCTS 185.0000 0.00 185.00 <br /> TOTAL CHARGE 185.00 <br /> CREDITS 0.00 <br /> ------------ <br /> TOTAL DUE 011E 185.00 <br /> UNPAID BALANCE THIS RECEIPT 185.00 <br /> GENERATOR STATUS <br /> 220-2200 lbs/month <br /> Customer certifies that (i) the deve-named materials are properly <br /> classified, packaged, marked end labeled, and ore in proper condition -" <br /> for transportation according to the applicable regulations of the <br /> Departmeot of Transportation (ii) nu material change has occurred <br /> either in the characteristics of the waste/matorial 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 /> this transaction. If Customer fails to make paymen when due, an <br /> amountequal to the lesser of (1) 1.5% per month (18% per annuaO or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> anounts outstanding. Customer certifies that the individual signing <br /> —th; q r,iur A L 9 nye _ i- A.y1 .-. h ,y_ d b' d <br />