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Brenntag Pacific, Inc 145572 <br /> Container Pick-up Receipt <br /> Customer: <br /> --=r" 7 <br /> Number � Name <br /> Address: �cr, c . r�G o�-Cbf g o <br /> Whs <br /> Product - Deposit <br /> Qty HM Drum Description Color Code Last Contained Value <br /> DRUM 8-1/2 GAL SS <br /> DRUM 55 GAL SS _ <br /> DRUM 15 GAL POLY <br /> DRUM 30 GAL POLY i <br /> 0RU <br /> M 55 GAL POLY OH <br /> DRUM 55 GAL POLY ACM <br /> ------------- <br /> VIDRUM 55 GAL POLY �F2 <br /> .— � ' 77 <br /> v-T ' <br /> --_ Dt2UM.55 GAL STEEi.. • — <br /> r <br /> CYLINDER 360 LB <br /> PALLETS <br /> VENDOR DRUM 55 GAL <br /> VENDOR CYLINDER <br /> IN CASE OF CHEMICAL EMERGENCY,CALL CHEMTREC 1.800-424-9300 <br /> Total Qty <br /> Empty Drum Certification <br /> I hereby certigy that these drums are"empty"as that tens is defined in the Environmental <br /> Protection Atency regulations,40 GFR 261.7,and that they have been properly prepared for j <br /> transportation under the regulations of the U.S.Department of Transportation;49 CFR 173.29 Total Credit: ?' l <br /> Customer: =✓ Nom. Date: i�/; ! o�/ Total Cleaning Charges: <br /> Driver: �` !/ ter: ;l\i Net Credit to Customer: <br /> igmture <br />