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General Petroleum REMIT TO: P 0. Box 31001-1235 <br />Corporation Pasadena, CA 91110-1235 <br />19501 S. Santa Fe Avenue Customer Service7(800) 659-5823 • Fax: (310) 356-2624 <br />Rancho Dominguez, CA 90221 Credit Inquiries:(310) 356-2400 <br />INVOICE0 <br />• •P.O.- •"mini or <br />DEL. TICKET N • • <br />BILLING ADDRESS: <br />TERMS: <br />SHIPPED TO: <br />COUNTRY CODE: <br />FOR CHEMICAL EMERGENCY <br />Spill, Leak, Fire Exposure orA06dent <br />CALL CHEMTREC - DAY OR NIGHT <br />800-424-9300 <br />CUSTOMER COPY <br />FOR COMPANY USE ONLY <br />RT [:1 <br />TF [I <br />OPE <br />ARRIVED LOAD POINT <br />AM DATE <br />COMPLETED LOADING AM DATE <br />TIME SPENT LOADING <br />TRUCK # <br />BIL # <br />PM <br />PM <br />ARRIVED DESTINATION <br />AM DATE <br />COMPLETED UNLOADING AM DATE <br />TIME SPENT UNLOADING <br />EXCESS TIME <br />PM <br />PM <br />END <br />GAS <br />DIESEL <br />OTHER <br />WATER DETECTED? <br />TEMPERATURE <br />GRAVITY <br />OAT.NAL,FWUSIMiEPoMSPucAR0.9 PROWEp <br />TANKun <br />❑ YES ❑ NO <br />NS� iTP i WigtEW ARE PROK:kv <br />BEGINNING <br />DRUM DEPOSIT <br />DRUM CREDIT <br />OUR PUMP <br />W 551FlE0, DES CRIB®, PACMAGED, M11tllED A)&1 UilH ED M10 ARE M <br />PROPER CONDInON FOR TRAr WAT*N ACCUONO ro , <br />TANKAPPLtaERECaATIDNSOFTFEMWTKRTOFTWJIS <br />❑ <br />❑ <br />MC TK)N <br />YES <br />NO <br />;: Ey$ AKAWOOUSMATEFWS <br />RECEIVED BY _ <br />DATE <br />LOADED I DELIVERED BY <br />DATE <br />INCCENi CNl EMERGp1CY PHONE +20PA]tiP900 <br />CUSTOMER COPY <br />