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CSG SK-SSL-BOX-23 Gomez,Raymond 07-30-2020 10:53 PAGE 1 <br /> Safety-Kleen Systems, Inc. <br /> 42 Longwater Drive <br /> Norwell, MA 02061 <br /> CORPORATE: 800-669-5740 <br /> 24 HR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE HER. <br /> CUSTOMER# OR14424 O'Reilly # 2765 83649419 - 2003386720 <br /> 430 Cherokee Ln SRVC WEEK: 2020-31 <br /> 39-C-02603 Lodi SRVC DATE: 07-30-2020 <br /> CA 95240 <br /> PHONE 209-333-7195 <br /> BILL TO CUSTOMER# BILL TO ADDRESS: <br /> OR10217 O'Reilly Auto Parts <br /> 233 S Patterson Ave <br /> Attn John Bounds <br /> Springfield <br /> MO 65802-2210 <br /> PHONE 972-265-2485 <br /> PURCHASE ORDER# TAX EXEMPT# <br /> PRODUCT/SERVICES <br /> SERVICE/PRODUCT QTY UNIT PRICE TAX TOTAL CHARGE <br /> 3369 DRUM, 55 GL BLACK STEEL OH NEW 0 TIER1 TIERI TIER1 <br /> CAUSE CODE VOIDHEADERANDLINE -SERVICE NOT NEEDED <br /> 3383 DRUM,55 GAL FOR O.F. 2.0 TIER1 TIERI TIER1 <br /> 8003369 DRUM, 55 GL BLACK STEEL OH RECON 2.0 TIERI TIER1 TIERI <br /> 156033 / 83383 DRUM,55 WASTE O.F. 2.0 TIERI TIERI TIER1 <br /> SERVICE TERM 52 WEEK <br /> 156033 / 83383 DRUM,55 WASTE O.F. 0 TIERI TIER1 TIER1 <br /> CAUSE CODE VOIDHEADERANDLINE -CANNOT ENTER WASTE <br /> SERVICE TERM 52 WEEK <br /> 874301 / 870600 LFB1-LP FOR FUELS BLENDING 55GL 0 TIER1 TIERI TIER1 <br /> CAUSE CODE VOIDHEADERANDLINE -SERVICE NOT NEEDED <br /> SERVICE TERM 8 WEEK <br /> 40559605 / 875460 CNO-NON HAZARDOUS SOLID 55GL 2.0 TIERI TIERI TIERI <br /> SERVICE TERM 24 WEEK <br /> CONT#: 2 TSDF:BL MANIFEST#: FORM CD:US SHIP#: 231953214 <br /> 007313714SKS <br /> CNT#: 200715563149 QTY: 150 WT/VOL P PROF#:40559605 SKDOT#: 7361257 <br /> CNT#: 200715563148 QTY: 150 WT/VOL P PROF#:40559605 SKDOT#: 7361257 <br /> 100001 FEE, FUEL SURCHAR 1.0 TIER1 TIER1 TIER1 <br /> 100065 E-Manifest Fee 1.0 TIER1 TIERI TIER1 <br /> 3230 TAX HANDLING N/C DRUM DROP 30 1.0 TIER1 TIER1 TIER1 <br /> TOTAL SERVICE/PRODUCTS <br /> TIER1 TIER1 TIER1 <br /> TOTAL CHARGE TIER1 <br /> CREDITS TIERI <br /> ------------------------------ <br /> TOTAL DUE TIER1 <br /> ------------------------------ <br /> UNPAID BALANCE THIS RECEIPT TIERI <br /> GENERATOR STATUS <br /> 0-220 lbs/month <br /> I have established a program to reduce the volume above-named materials are properly or quantity and toxicity of the <br /> hazardous waste to the degree to be economically practicable. labeled, and are in proper condition for transportation <br /> according to the applicable regulations of the Department of Transportation (ii) no material change has occurred either <br /> in the characteristics of the waste/material or in the process generating the waste/material, and (iii) the above <br /> referenced Generator Status is correct. Customer agrees to pay the above charges and to be bound by the terms and <br /> conditions (1) set forth in (a) the General Terms and Conditions provided separately to Customer or (b) any SK agreement <br /> signed by Customer and SK, and (2) incorporated herein by reference. Unless otherwise indicated in the payment received <br /> section, SK is authorized to charge Customers account for this transaction. If Customer fails to make payment when due, <br /> an amount equal to the lesser of (i) 1.5% per month (18% per annum) or (ii) the maximum amount allowed by law, will be <br /> added to all unpaid amounts outstanding. Customer certifies that the individual signing this Service Acknowledgement is <br /> duly authorized to sign and bind Customer. Customer acknowledges that it is responsible for maintaining its Generator <br />