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Iff Universal Environmental, Inc. 25946 <br /> 4101 Industrial O Box 996 Benicia, CA 94510 707-747-6699 <br /> HAZARDOU ASTE HAULING REMEDIATION INDUSTRIAL CLEANING <br /> DISC 3240 ICC# MC27 664 <br /> MANIFEST# DATE <br /> PO # <br /> CONTACT , JOB# <br /> CUSTOMER <br /> ___(�ON 0 <br /> JOB LOCATION <br /> I T Y F '���•�/ STAT <br /> SERVICES PERFORMED t <br />' <br /> DELIVER BIN# .41 <br /> PICK UP BIN# <br /> 1 PRODUCT xr� ORIGIN DEST,fTl N <br /> ARRIVE JOB '� ARRIVE DISPOSAL <br /> DEPART JOB `� C7--_ PgPART DISPOSAL <br />' TRUCK# TRAIL � �R# STARTjP5 0 STOP � IME HOUR <br /> CAPACITY TIME OUT �,f TO LESS HOUR <br />'# LOADS DM/YD/LBS/GALS 4 ' LINER W/O NET HOUR <br /> DISPOSAL SITE • PER DIEM TOLL <br /> DRIVERS NAME LABORER <br /> DRIVERS SIGNATURE CUSTOMER AUTHORIZATION <br />' NOTE In the event of action or proceeding upon this agreement the court shall award to the prevailing party court costs and resonable attorney fees <br /> Interest will be charged at the rate of 1 1/2%per month(18%per annum)on all overdue accounts <br /> 1 <br />