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nC61 <br /> NORTH COUNTY RC & LANDFILL CSG SK-BWP-UMO-01 Hernandez,Nelson <br /> 03-08-2022 0$:01 PAGE 1 <br /> 17720 EAST-HARRY LANE Safety—Kleen Syste ns, Inc. <br /> LODI, CA 887-3868 42LongwaterDrive <br /> MON - SUN 7AM TO 4PM Norwell,MA 02061 <br /> CORPORATE:800—669-5740 <br /> Weighed: Robynns 24 HR EMERGENCY;800-468-1760(88fety-141ee11) <br /> Deposit: Robynne 2095451011 <br /> BILL T0: Q REFERENCE NBA, <br /> CI'STOMER# N027163 North County Recycling Canter And <br /> 88531447—2107794180 <br /> Sanitary Landfil <br /> 17720 E Harney Ln ERVC WEEK:2022-10 <br /> Lodi CA 95240-9623 ERVC DATE:03-08-2022 <br /> Vehicle ID: W PHONE 209-887-3868 <br /> Reference; 1705903 <br /> COMPANY: SAFETY KLEEN BILL TO CUSTOMER# BILL TO ADDRESS: <br /> PHONE #: FC=60 N027163 North County Recycling Center And Sanitary <br /> Landfil <br /> Origin: SALVAGE 17720 E Harney Ln <br /> 96240-9623 <br /> DATE IN: 03/08/2022 TIME IN: 07:02:13 Lodi <br /> PHONEE 2009-889-88 7--93 <br /> 868 <br /> DATE OUT: 03/08/2022 TIME OUT: 07:50:01 PURCHASE ORDER# 63917 TAX EXEMPT# <br /> OUTBOUND TICKET Number; 58-•00686035 PRODUCTISERUICES TOTAL <br /> SERVICES/ <br /> SCALE 2 GROSS WT. 26500 LB PRODUCT <br /> OTY UNIT PRICE TAX CHARGE <br /> 10256 FEE,OIL 1,0 120.00 0,00 120.00 <br /> SCALE 2 TARE WT, 21200 LB SERVICEISTOP <br /> NET WEIGHT 6300 LB NON—PREQUAL <br /> CRANKC <br /> Qty Description Amount SERVICE TERM 4WEEK <br /> 2.65 OIL SALVAGE 0.00 66636 USED OIL 755,0 0.25 O.OD 168.75 <br /> RECYCLE <br /> TICKET AMOUNT: 0,00 AUTOMOTIVE OIL <br /> SERVICE TERM 4 WEEK <br /> HALOGEN/CLOR—D—TECT TEST: NOT PERFORMED <br /> REGULATORY STATUS:KNOWLEDGE VSOG EXEMPT PER 40CFR279,10(b)(3) <br /> ----------------------------- <br /> TOTAL SERVICE/PRODUCTS <br /> X 120.26 0,00 308,76 <br /> TOTAL CHARGE 308.75 <br /> CREDITS 0100 <br /> -------------------------- <br /> TOTAL DUE 908.76 <br /> --------------------------- <br /> UNPAID BALANCE THIS RECEIPT 308.75 <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 /> CES(1G:Vehicle <br /> Customer certifiesthat Q)the I have established a program to reduce the volume <br /> above—named materials are properly or quantity and toxicity 0 the hazardousweste <br /> classified,packaged,marked and to the degree to be ecenomlcally practicable,labeled, <br /> and are In proper condition for transportation according to the applicable regulations of <br /> the Department of Transportallon 01)no material change has occurred either in the <br /> characteristics of the wadi rreterlal or in the process generating the wasielmaterial,and <br /> QIQ the above referenced Generator Status Is correct.Customer agrees to pay the above <br /> charges and to be bound by the terms and conditions(1)set forth In(a)the General Terms <br /> and Conditions provided separately to Customer or 0)any SK agreement signed by Customer <br /> and SK,and 2)Incorporated herein by reference, Unless otherwise Indicated In the <br /> payment received section,SK Is authorized to charge Customers account for this <br /> transaction,If Customer failsto make payment when due,an amount equal to the lesser 0 <br /> Q)1,646 per month 08%per annum)or QQ the maximum amount allowed by low,will he <br /> added to all unoeid amounts outstanding,Customer certHiesthat the individual signing <br />