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CALARNIA COOLANT SERVICE <br />" YourCaliforniaAntrfreeze Service Company" <br />1 187 VANDERBILT CIR. #2 <br />MANTECA, CA 95337 <br />OFFICE: 209-239-5587 <br />FAx: 209-239-6316 <br />INVOICE NO: M 9 8 6' nr <br />Customer Authorization: X Date: X <br />CCS Representative: X Date: X <br />All returned checks are subject t4 W5.00 Service Charge. <br />Allamounts not paid within 30 days of Invoice are subject to 1 112% interest per month, 18% annually on unpaid balance. <br />INVOICE NO: <br />HAZARDOUS WASTE RECEIPT <br />MANIFEST DOCUMENT NUMBER <br />.. Im—ra.ke°k lane <br />WASTE NAME ........... Non RCRA Hazardous / Waste Anti -Freeze <br />Cherokee kee Srd og <br />90,0 S. Chwrokee Latw <br />CLASSIFICATION .............................................. Non RCRA Waste <br />ID#............................................................................................ #134 <br />Lodi, C! 95240 <br />209-365-9834 <br />0 ta- I Ci _ Tiflar )C*r ft <br />,� (-"i ' �? <br />TRANSPORTER'S NAME: CALIFORNIA COOLANT SERVICE <br />1187 VANDERBILT CIR #2 <br />MANTECA, CA 95377 (209) 239-5587 <br />�nvalc 94=-..__..._.._x.._.._v�.�.uWWMer* 2"9 Terms: <br />Due on s Lulu�a anado <br />CAR 000047167 <br />CUSTOMERS SIGNAT RE / PRINT / DATE <br />AUTHORIZED WASTE FACILITY: <br />1=- i <br />DRIV� S S . TURlI AND DATE GALLONS <br />P <br />/i <br />UTD 982 589 459 <br />ra -1 U <br />iyCii�� r�3i"t?i;.°�E? �ai�lt <br />Tank Serial Numbers: <br />Non Taxable Sub Total <br />Taxable Sub Total <br />Tax <br />TOTAL DUE <br />:rt <br />Customer Authorization: X Date: X <br />CCS Representative: X Date: X <br />All returned checks are subject t4 W5.00 Service Charge. <br />Allamounts not paid within 30 days of Invoice are subject to 1 112% interest per month, 18% annually on unpaid balance. <br />INVOICE NO: <br />HAZARDOUS WASTE RECEIPT <br />MANIFEST DOCUMENT NUMBER <br />GENERATOR'S NAME & MAILING ADDRESS <br />WASTE NAME ........... Non RCRA Hazardous / Waste Anti -Freeze <br />Cherokee kee Srd og <br />90,0 S. Chwrokee Latw <br />CLASSIFICATION .............................................. Non RCRA Waste <br />ID#............................................................................................ #134 <br />Lodi, C! 95240 <br />209-365-9834 <br />0 ta- I Ci _ Tiflar )C*r ft <br />,� (-"i ' �? <br />TRANSPORTER'S NAME: CALIFORNIA COOLANT SERVICE <br />1187 VANDERBILT CIR #2 <br />MANTECA, CA 95377 (209) 239-5587 <br />TRANSPORTER'S U.S. EPA ID NO. <br />CAR 000047167 <br />CUSTOMERS SIGNAT RE / PRINT / DATE <br />AUTHORIZED WASTE FACILITY: <br />1=- i <br />DRIV� S S . TURlI AND DATE GALLONS <br />NU -SET INDUSTRIES <br />977 SOUTH 700 WEST <br />SALT LAKE CITY, UT 84104 (801) 977-0220 <br />WASTE FACILITY U.S. EPA ID NO. <br />/i <br />UTD 982 589 459 <br />J .za <br />