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Ift <br /> o41 <br /> so TAG NO. <br /> 'Dillard Envi.ronn�ental �Serj�W_ <br /> S-1Ru101-8 PO Box 579 18655 <br /> Byron, CA 94514-­ <br /> Telephone <br /> 45l -.Telephone.No. (9%� 44- )850 <br /> Facsimile No. {92 -0509 <br /> Date <br /> 1' 308 i3UlS8EF25(5) .JOB NUMBERS(S) � ;_�JOB 1IUP116ER5(S}> � ��°JOB Alt A'SEE�5(5� <br /> -...... <br /> ! <br /> TRUCK No <br /> TRAJLER # , � # v # # <br /> #E ' _.... <br /> SUIS:' # # # # <br /> HAULER <br /> PRIME .. <br /> CARRIER CONSIGNEE <br /> r '3 ;' <br /> GENERATOR(S) DESTINATION <br /> CITY <br /> CITY{ yi } f` Car BEGINNING MJENA1LE <br /> ILEA E DIGE <br /> ­MATERIALS.,,­,-, Lt7AT IteI L FUEL-GALLONS FUE€-VENDOR <br /> i . _ mJPIIOXtL3INC� ,� #1 #2 #9 #2 <br /> MANIFEST _'*(DSOR t1#! r.Td�tiE iIFE TIME .. <br /> N43 No. WEIGHT.. :.-ARR#UE LE1x€!E ARRVE 4:LEAVE <br /> 1 <br /> .2 ✓ <br /> /, ✓{ 5 'er"6 ,OFFICE USE ONLY <br /> TNS i HRS l LDS YQQS , <br /> 5 TRANSPORTATION UNITS- <br /> S TRANSPORTATION RATE: <br /> 7 r r a"�1 I SUBTOTAL: $ <br /> DISPOSAL UNITS: 1 <br /> DISPOSAL RATE: <br /> tt SUBTOTAL: $ <br /> 12 <br /> t3! BRIDGE-TOLL: <br /> A COMMENTS: <br /> ,01 _ �.. � / ' �f Y1?�/ MATERIALS: <br /> START sfaP DEDUCT NET <br /> f TIME TIME <br /> DRIVER <br /> RECEIVEtI DATE APPROVED BY <br /> TOTALCHAROES:' $ <br /> TERMS and CONDITIONS <br /> Payfnei nt terms are ripe thirty(30)clays subject to a charge of I.59A Perrnonlhon all past due balanCe.S.In 11,9 event the account tyr�cc meS de!inQuenl arxf d is necessa:yio mstltute <br /> legal proceedings,CUSTOMER agrees to pay DES`attorney's fees'interred;n such proceeding,action or suit or In any appaal thereon,The parties agree that actions or <br /> prnccedings arising In connect?art with;his agree Want shalt be tried and tiltgated exclusively in the courts loratod in Contra Costa County.Cawamia. <br />