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op <br />" R CLING <br />E Gy? <br />142 S. Aurora St. Stockton, Ca 95202 <br />(209) 463-7600 Fax (209) 463-7600 <br />VICTOR M;FN EL GONZALEZ <br />793 1A MESA C`:i' . <br />MANTECA Ca 95336 <br />Phone Number: NONE <br />Employer Name: <br />Employer Phone: <br />ID NBR: <br />VehicleTag/St/VIN: <br />> TCf012'�Y,kt EL.G_ON:r1l Eln <br />Ln Mise cT <br />NPNI£fA CA 95336 <br />CSFX:M HAMBRN FIl <br />HT,5-08 MT: 150 LllSri <br />.;t.; _ . WWII a4 siulm., <br />p rl C'.I l; tll. <br />i <br />21 - <br />Fridge/Freezer (4.00ea) PC: <br />0 <br />Weight: 1 <br />Rate: 4.50 <br />$4.50 <br />CASH <br />SETTLEMENT TIctNbr: 26703 <br />Date: <br />1/16/2013 <br />Time: 13:21:33 <br />$4.50 <br />ACKNOWLEDGMENT OF SELLER <br />Seller hereby warrants and certifies by his signature or check endorsement that <br />he/she is rightful owner or agent of the property described above and has the <br />right to possess and sell the property and has never been convicted of a scrap crime. <br />The seller further warrants that material delivered for sale does not contain <br />hazardous or dangerous properties as defined under current Federal and State regulation. <br />Seller certifies that prior to entering Tri Valley Recycling <br />that all CFC's have been properly removed to allow legal, safe, and responsible recycling <br />under Section 608(H)(1) of the Clean Air Act. <br />Seller Signature: <br />RECEIVED <br />NOV 0 4 2013 <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />