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J <br /> CSG SK-SSL-BOX-24 David Mccarroll 03/02/20 11.43 PAGE 1 <br /> Safety-K1eeni Systems, Inc. <br /> 2600 N Central EXpy, Suite 200 <br /> Richardson, TX 75050 <br /> CORPORATE; 800-669-5740 <br /> 24 HR EMERGENCY., 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> CUSTOMER# TR24225 Tracy Public School Dist REFERENCE 77 <br /> 82402314-200076770101 <br /> - <br /> 1975 W Lowell Ave SRVC WEEK; 2020-10 <br /> Tracy CA 95376-•2238 / SRVC DATE: 03/02/20 <br /> PHONE 209-831-5015 <br /> RILL TO CUSTOMER# BELE. TO ADDRESS., <br /> TR24451 Tracy Public School Dist <br /> 1875 W Lowell Ave <br /> Tracy CA 95376-2291 <br /> PHONE 209-830-3216 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> I11 PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 81983 MODEL 81.8 W/6365 1,000 686,0000 56,60 742.60 <br /> !!!! SJN 17028120 TAG 00001078SR17028120 CLEAN 4.00 SPENT 0.000 <br /> SERVICE TERM 8 WEEK SCANNED YES <br /> ----------------------------------------- <br /> TOTAL SEMCE/PRODUCTS 686.0000 56.60 742,60 <br /> TOTAL CHARGE 742.60 <br /> CREDITS 0.00 <br /> TOTAL DUE -- - - <br /> 742.60 <br /> i�' ,_i UNPAID BALANCE THIS RECEIPT 742.60 <br /> 'L.., i <br /> , <br /> Machine clean and good condition? Yes <br /> , 1 Lamp Assembly Condition Yes <br /> - Decals in place and legible? Yes <br /> �ttCl <br /> Fusible link installed? Yes <br /> I Emargency 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 /> _ I <br /> `I <br /> GENERATOR STATUS <br /> I0-220 lbs/month <br /> ' Customer certifies that (i) the above-named materials are properly <br /> classified, packaged, marked and labeled, and are in proper kendition <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 /> May to flay <br /> Obla Date, <br /> o T <br /> z _ Approval: ��. <br />