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<br /> STATE MANIFEST#1.�-
<br /> "� ox.1167 k IMS`. ��°r.
<br /> 13331 N. Hwy 331 P.O. B USED OIL HAULER# 86 aso "�a P "
<br /> CAD0831
<br /> EPA# 66728
<br /> Patterson, CA 95363
<br /> HAZARDOUS WASTE4w
<br /> 299 892-67421 {8U(}) 874-4444 HAULER REG#_ 2501
<br /> INV.# 82236
<br /> INTERVAL DAT E ,..
<br /> DRI
<br /> uclCI
<br /> NAME +:t cE
<br /> t} � BILLIN®nOORE$9 IF nIFFEHEHi rl CASH
<br /> S noon 1, / IN AY.
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<br /> rl I�j41 It��y��•�?,••R�r i{ �.
<br /> . PLEASE PAY FROM THIS INVOICE i is k! ,Gd .qtr
<br /> AMOUNT It'+�; r $S 4
<br /> RATE ;rtd,' {rf ,
<br /> GALLONS HOURS
<br /> PRODUCT
<br /> - • .,rv.uJ't i4 raj. �}r�t5 t:
<br /> HAZARDOUS WASTE OIL
<br /> TEST FEE
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<br /> HAZARDOUS WASTE A
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<br /> " CHARGES ;} il' 3 -.";U1
<br /> �t,}i,z.
<br /> HOURLY
<br /> I certil amount si above to be correct.
<br /> tlrr }L4 ':
<br /> (ori r Signature)
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<br /> [Cus(omer Signalura} � •fir}1}��?�S r fstx a .,
<br /> {_ TOTAL CHARGES i Lttkr� :r{tits`:
<br /> rv�ceto institute 'itla + �
<br /> PAYMENT DUE UPON RECEIi�T OntIN SOI count becomes del nquent a d ft s necessary o charged
<br /> on all past due aCCUunts. In the.e Be and COtJft GOSlS. .','s3p{t,tykrrSs
<br /> legal proceedings,purchases agrees to pay reasonable attorney's f Nt�1,`;�
<br /> }-,t WHITE:Customer CANARY:A1ph�licai
<br /> PINK:Nun enc
<br /> GOLDENROD File
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