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CSG SK-SSL-BOK-25 Bruce Maeberry 08/31/18 14:11 PAGE 1 <br /> Safety-Meen Systems, Inc. <br /> 2500 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 500-669-5740 <br /> 14 HR EMERGENCY: 800-468-1760 Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NBR. <br /> CUSTOMERN LK00044 Lkq 7'7607403-1803980490 <br /> 2041 Navy Dr SRVC WEEK: 2018-35 <br /> Attn Jerry SRVC DATE: 08/31/18 <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> LK00044 Lkq <br /> 2041 Navy or <br /> Attn Jerry <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 <br /> PURCHASE ORDER# TAX EXEMPT4 <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRIDE TAX CHARGE <br /> 90837 MODEL 90 W12381 & 6365 1.000 389.8500 35.09 424.94 <br /> SIN 118982 TAC, T0006000xxA0209511 CLEAN 2.50 SPENT 0.000 <br /> SERVICE TERM 12 WEEK SCANNED YES <br /> 100001 FEE, FUEL SURCHARGE 1.000 13.4800 1.21 14.69 <br /> TOTAL SERVICEIPRODUCTS 403.3300 36.30 439.63 <br /> TOTAL CHARGE 439,63 <br /> CREDITS 0.00 <br /> TOTAL DUE 439.63 <br /> UNPAIIs BALANCE THIS RECEIPT 439.63 <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 /> Emergency closing of lid unobstructed? Yes <br /> Machine properly grounded? Yes <br /> Local Phone No. Sticker Affixed to Machine Yes <br /> Spent solvent meats acceptance criteria? Yes <br /> GENERATOR STATUS <br /> 0-220 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 the process <br /> generating the waste/material, and till} the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and tc 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 payment when due, an <br /> amount equal to the lesser of (l) 1.58 per month (181 per annum) or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the individual signing <br />