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CSG SK- SSL-UM0- 01 Joseph R Lima Jr 06 / 04 / 18 08 : 37 PAGE 1 <br /> Safety = Kleen Systems , Inc . <br /> 2600 N Central Expy , Suite 200 <br /> Richardson , TX 75080 <br /> CORPORATE : 800 - 669-5740 <br /> 24 HR EMERGENCY : 800 - 468 - 1760 ( Safety-Kleen ) <br /> 2095451011 <br /> REFERENCE NBR . <br /> CUSTOMER# HE28099 Heartland Express of Iowa Inc 77078909 <br /> 12550 Harlan Rd SRVC WEEK : 2018 - 23 <br /> Lathrop CA 95330 - 0000 SRVC DATE : 06 / 04 / 18 <br /> PHONE 800 - 426- 6010 <br /> BILL TO CUSTOMER# BILL TO ADDRESS : <br /> HE28099 Heartland Express of Iowa Inc <br /> 12550 Harlan Rd <br /> Lathrop CA 95330- 0000 <br /> PHONE 800 - 426 - 6010 <br /> PURCHASE ORDER# TAX EXEMPT # '.. <br /> PRODUCT/SERVICES <br /> SERVICE / TOTAL '.. <br /> PRODUCT QTY UNIT PRICE TAX CHARGE '.. <br /> 10256 FEE , OIL SERVICE / STOP NON 1 . 000 150 . 0000 0 . 00 150 . 00 <br /> SERVICE TERM 8 WEEK <br /> 66636 USED OIL RECYCLE AUTOMOTI 455 . 000 0 . 0000 0 . 00 0 . 00 <br /> SERVICE TERM 8 WEEK <br /> HALOGEN / CLOR- D-TECT TEST RESULT PASS : PPM < 1000 <br /> TOTAL SERVICE / PRODUCTS 150 . 0000 0 . 00 150 . 00 <br /> TOTAL CHARGE 150 . 00 <br /> CREDITS 0 . 00 <br /> TOTAL DUE 150 . 00 <br /> ---- -- --------- <br /> UNPAID BALANCE THIS RECEIPT 150 . 00 <br /> If high risk source , rep . certifies that load specific PCB & Silicon <br /> testing have been completed prior to pumping this load . <br /> GENERATOR STATUS <br /> CESQG : Vehicle <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 ( 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 payment when due , an <br /> amount equal to the lesser of ( i ) 1 . 5 % per month ( 18 % 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 /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer . Customer acknowledges that it is responsible for maintaining <br /> its Generator Status and obtaining an EPA ID number if required by <br /> applicable law . The following provision is applicable to <br /> Safety-Kleen ' s parts cleaner and paint gun cleaner services : Customer <br /> agrees that it will not introduce any substance into the solvent or <br />