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'® RUDy-gONZ <br /> INS- - <br /> ® , <br /> INDUSTRIAL v` <br /> PHONE 2650 W,HATC E DISPpSAL <br /> MODESTp, CALIF. ROAD <br /> 538-1430 95358 <br /> DATE r —� W/T# <br /> CUST0M� � <br /> R . off ; t COST# <br /> A � <br /> DDRESS ' — <br /> DRIV`,,..�..-..� <br /> I ER <br /> BIN f T i .f`OBE REPLACED - CALIF. <br /> JD My <br /> ;YES Q..1 NO TRUCK NO _7 1 <br /> METAL �[ WEIGHT <br /> PAPER ^p Q 5�,L e} `J�,air Q. YDS. <br /> CANS, USED <br /> CONCRETE OR DIRT <br /> CANNED GOODS <br /> WASTE WET <br /> TRASH <br /> COMPACTED TRASH <br /> COMPACTED PAPER <br /> WOOD <br /> SPECIAL BURIAL <br /> CUSTOMER'S r" <br /> SIGNATURE X <br /> Customer acknnitowledges contai <br /> good and sa'no � <br /> that extraspecific 7 order and not "rd,,,on received in good <br /> containerfees°Pd domog(ea rousted b d in' (2(to PI 2�0di <br /> 00 condition and o <br /> fo indemnexcludin excessana and cement 9rees (1( ro maintain <br /> g reasonable Y such overl lbs in an only in containers it <br /> rev sonable�and hold collector wear and tear oadingm(a41A to reimbb encollectornaf an ProviP°y all <br /> attorneys fees and costs°Forla�from dd 9e roused °9rees to <br /> Y acflon claim For injury to°riloiled r or its emPd°yee9e(5 ! <br /> required in connection with thispo fee°qd I61 to pa I <br /> Y S. WRITE BELOW THIS 9 ment. y <br /> CU. YDS, uNE j <br /> CU. YDS, d <br />