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�0a <br /> T td t .rd 61,vironmental Services <br /> TAG NO. <br /> ° <br /> 18854 <br /> PO:Box 579 <br /> s�IRvIG� Byron, CA 94514 <br /> Telephone No. (025) 634-6850 <br /> Fzcsinii:le No (925) 634-0569 <br /> rv^ iCaB NCthti3ERS{5} `x JOB NUM5ERS(S3 �q 5P-JOB t+O"ERSiS� <br /> fDate- <br /> # <br /> _ _- <br /> TRUCK TRAILER # # <br /> NO, - NO. <br /> sue, # # # # <br /> I <br /> HAULER <br /> PRIME ? CONSIGNEE <br /> F CARRIER <br /> GENERATORS) { " DESTINATION <br /> i� p / <br /> F CITY - <br /> qaM_ BEGiNNiNG MILEAGE MILEAG� <br /> CITY ' } <br /> ENDING <br /> ,. :... DOR <br /> FUEL-GALLONS FUEL #2kSATEf21ALS - �? LOAQING y UNLOADit 1t3 -.#1 #2 #I #2 <br /> _ ktANIfEST- YARDS OR �ARRIVE VE TIh�E T IE <br /> TSE; ,E: <br /> 1. <br /> NO �".. m,x>- ., VfEIfiHTLEJ17E _ h$FtIV LEAVE�" <br /> a -� <br /> 2 *' I � t� <br /> 3 ! OFFICE 115E ONLY <br /> i. — -......_. - <br /> I i _�:__...._ TNS j HRS 1 LDS,!YDS <br /> 5 TRANSPORTATION UNITS: <br /> ra ., w-^� TRANSPORTATION RATE:SUSTOTA <br /> ilY <br /> DISPOSAL UNITS: <br /> ��- <br /> to DISPOSAL(ATI <br /> FSUBTOTAL: $ <br /> 1 <br /> 121, <br /> 93, <br /> BRIDGE-TOLL: <br /> F <br /> coMltilENrs: MATERIALS: <br /> START STOPTDIME CT N ARE <br /> DRIVER <br /> RECEWED DATE APPROVEDSY TOTAL C1#dtFtIM£S: $ <br /> TERMS and CONDITIONS <br /> Paymenttorma are net thirty(36)drays subject to charm o€1.5%per month cn all.peat due tWances,In tlae event the ecnaunt becomes delingvsni and it is necessary to instituta <br /> legal prtceedings,CUSTOMER agrees to pay DES'attorney's tees incurred-in Such proceeding,action cr su';t or in any appeal thereon.The parries agree that actions at <br /> proceedings arssing in ounnsabn with this anreemos nt shall be tried and litigated exclusively In the courts topated in C.Onlrtt Costs County,CaMornis. <br /> F <br /> f <br />