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s �. <br />.,.m <br />RECYCLING <br />142 S. Aurora St. Stockton, Ca 95202 <br />(209) 463-7600 Fax (209) 463-7600 <br />,,7.11, NLriiTU. I GONZALEZ <br />-jANTE(i--. Ca 95336 <br />Phone Number: NONE <br />.x'.oy�r N -ma:. <br />Employer Phone: <br />ID NBR: <br />VehicleTag/St/VIN: <br /> <br /> <br /> <br /> <br /> <br /> <br />'! li. , � 'I (!'' ....'h. I� 13•.,. t:_,.•ir... v.;(s�►-:Ic'I;�.d <br />Cellilicaic. <br />;� .. Ur�. <br />ivnamltvi, rt ' oud fmd A.Urictiliw-,; <br />02B <br />- MISC EWASTE (.05) <br />PC: 0 <br />Weight: 736 <br />Rate: .06 <br />$44.16 <br />06 - <br />E -WASTE 1-400LB (.01) <br />PC: 0 <br />Weight: 109 <br />Rate: .02 <br />$2.18 <br />CASH <br />SETTLEMENT TktNbr: <br />28112 Date: <br />3/16/2013 <br />Time: 13:51:33 <br />$46.34 <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 sellerfurther 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(B)(1) of the Clean Air Act. <br />Seller Signature: <br />RECEIVED <br />NOV 0 4 2013 <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />