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BRANCH SSL CSG PW-24 David L Buxton 06/03/15 12:47 PAGE 1 <br /> Safety-Keen Systems, Inc. <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 15080 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 600-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NRR. <br /> CUSTOMER# LK00044 Lkq 67541299 <br /> 2041 Navy Dr SRVC WEEK: 2015-32 <br /> Attn Jerry SRVC DATE: 88/03/15 12:45 <br /> Stockton CA 95206-1142 <br /> PHONE 209-4614--1111 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> LK00044 Lkq <br /> 2041 Navy Dr <br /> Attn Jerry <br /> Stockton CA 95206-1142 <br /> PHONE 209-464-1111 <br /> PURCHASE ORDER# TAX EXEmPTN <br /> PRQDUCUSERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 90837 MODEL 90 w/2387 & 6365 1.000 316.0500 28.44 344.49 <br /> SIN 118982 TAG T0000000XX90209571 CLEAN 3.00 SPENT 0.000 <br /> SERVICE TERM 12 WEEK SCANNED YES <br /> 100041 FEF, FUEL. SURCHARGE 1.000 11.8200 1,06 12.88 <br /> TOTAL SERVICE/PRODUCTS 327.8700 29.50 357.37 <br /> TOTAL CHARGE 351.37 <br /> CREDITS 0.00 <br /> -------------- <br /> TOTAL DUE 357.37 <br /> UNPAID BALANCE THIS RECEIPT 357.37 <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 meets acceptance criteria? Yes <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> Customer certifies that (ii 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 and [il) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material. Customer agrees to pay the above <br /> charges and to be bound by the terms and conditions ill set forth in <br /> (a} the General Terms and Conditions provided separately to Customer <br /> or Lbf any SK agreement signed by Customer and SK, and (2) <br /> incorporated herein by reference. Unless otherwise indicated in the <br /> payment received section, SK is authorized to charge Customer's <br /> account for this transaction. Customer certifies that the individual <br /> signing this Service Acknowledgement is duly authorized to sign and <br /> bind Customer. The following provision is applicable to Safety-Kleen'S <br /> parts cleaner and paint gun cleaner services: Customer agrees that it <br /> will not introduce any substance into the solvent or aqueous cleaning <br />