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CSG SK-SSL-BOX-23 Raymond Gomez 05 /04 /20 14 : 04 PAGE 1 <br /> Safety-Kleen Systems, Inc . <br /> 42 Longwater Drive <br /> Norwell , MA 02061 <br /> CORPORATE : 800-669-5740 <br /> 24 HE EMERGENCY : 800-468-1760 ( Safety-Kleen ) <br /> 2095451011 <br /> REFERENCE NBR , <br /> CUSTOMER# RE32745 Remco 82931777-2001949653 <br /> 1627 Army Ct Ste 1 SRVC WEEK : 2020-19 <br /> Stockton CA 95206-0000 SRVC DATE : 05/ 04 /20 <br /> PHONE 925-447-0805 <br /> BILL TO CUSTOMER# BILL TO ADDRESS : <br /> RE32745 Remco <br /> 1627 Army Ct Ste 1 <br /> Stockton CA 95206-0000 <br /> PHONE 925-447-0805 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 53830 COMB MDL 53 AQ/ 6365 1 . 000 165 . 1500 0 . 00 165 . 15 <br /> S/N 98765 CLEAN 3 . 00 SPENT 0 . 000 <br /> SERVICE TERM 12 WEEK <br /> 90837 MODEL 90 W/2387 s 6365 1 . 000 108 . 9000 9 . 80 118 . 70 <br /> S/N 18030031 TAG 00001170SK18030031 CLEAN 2 . 50 SPENT 0 <br /> SERVICE TERM 12 WEEK SCANNED YES <br /> 100030 RECOVERY FEE 1 . 000 15 . 0700 1 . 36 16 . 43 <br /> ------------_ --____ <br /> TOTAL SERVICE/ PRODUCTS 289 . 1200 11 . 16 300 . 28 <br /> TOTAL CHARGE 300 . 28 <br /> CREDITS 0 . 00 <br /> --------------- <br /> TOTAL DUE 300 . 28 <br /> UNPAID BALANCE THIS RECEIPT 300 . 28 <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 ( 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 /> red <br /> either in the characteristics of the waste/material o n 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 bythe 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 i <br /> authorized to charge Customer ' s account for <br /> thistransaction . If Customer fails to make payment when due , an <br />