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RUDY BONZI, 1� ,,. ; ® RL BONZI, INC. <br /> 11 <br /> ® INDUSTRIAL WASTE DISPOSAL - INDUSTRIAL WASTE DISPOSAL <br /> 2650 W. HATCH ROAD I 2650 W. HATCH ROAD <br /> PHONE MODESTO, CALIF. 95358 � PHONE MODESTO, CALIF. 95358 <br /> 538-1430 W/T#_ 538-1430 W/T# <br /> r <br /> DATE f OUST# ) DATE Is' - CUST# <br /> CUSTOMER,, r'r" CUSTOMER.r�- !�.%. :•. .:J' n . <br /> i <br /> ADDRESS Z I , CALIF. ADDRESS r'o : , CALIF. <br /> DRIVER _ TRUCK NO. I DRIVER - i'.. TRUCK NO... <br /> BIN TO BE REPLACEDx YES O' NO❑ BIN TO BE REPLACED YES© NO❑ <br /> COMMODITY W H . YDS. COMMODITY IGT D <br /> METAL !! METAL <br /> PAPER PAPER <br /> CANS,USED ` CANS USED <br /> 'CONCRETE OR DIRT L• CONCRETE OR,DIRT �U e <br /> CANNED GOODS CANNED GOODS <br /> WASTE WET WASTE WET <br /> TRASH TRASH <br /> COMPACTED TRASH COMPACTED TRASH <br /> COMPACTED PAPER COMPACTED PAPER <br /> WOOD WOOD <br /> SPECIAL BURIAL G?p SPECIAL BURIAL <br /> CUSTOMER'S G - CUSTOMER'S <br /> SIGNATURE X - 7 SIGNATURE X <br /> Costumer acknowledges container was mi in good condiggr,and ogresses (1) ro moiniain II in Customer aalmowledges container was revived in good conditions and agrees P).to malmain 3 <br /> and and sanitary order and condition, (21 to place dirt and cemenl only m containers provided for god and nisi ardor and condiNon, (2)Ig place die and cement only in amita rri pro.ided for <br /> Sat speabc purpose, (3)not to load in excess of 20,000 lbs in any container and agrees to pay all that specific purpose, 13)net to load in es:uss of 20.000 lbs in any container and agrees to pay all <br /> ease fees aM damages os ed by such overicau g, (4) to reimburse c Ileclor for any damage so antra fees ami damages ca sed a such owaloodin . (41 m reimburse collector for any damage ro <br /> container ,scludin se b6 r and new and d mag caused by Iledor or its employees. 15) wntamer dudinp reasonable r and Ines and ,mag mused by collecbr or its emdaye , (5) <br /> ta indemnify and Mld collecror harmless from ars,datm for injury to o third part',aM 16I ro pay es ndemnify and hold ollecter harmless from any claim for injury ro o third parry, and(o)a pay <br /> rcason2"nttamays fen and costs for any action required in cannMion with this agreement. rmsonobfe attorneys fees and costs jar any edicts required in cunni with Ibis et neement. <br /> DO NOT WRRE BELOW THIS LINE DO NOT WRITE BELOW THIS UNE <br /> CU.YDS. ,; CU.YDS. <br /> CU.YDS. I CU.YDS. <br /> s <br /> d <br /> BT ' eEZ =OT 60 b0 JeW <br />