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C <br />U <br />S <br />T <br />C <br />N <br />E <br />R <br />A <br />B <br />C <br />C <br />i CUSTOMER <br />AIM 1381 rprvaie Rtrppt - SI litp inn //712 DUNS NO. 05-397-6551 FED. ID NO, 5 396090019 <br />Columbia, South Carolina 29201 � <br />FOR SERVICE CALL <br />BRANCH MANAGER <br />DOC. EXP. <br />SCHEDULED SCHEDULED <br />SERVICE WEEK TERRITORY <br />-pp CC� <br />"'gtd <br />T /� r q a$ <br />(c d 4 <br />l'a,S <br />Bfetq•NleeN• CUSTOMER NO. <br />t 3 s <br />.aJ :! °`..%d �.J "L.I ..ti i.3 G, i;�i:: �'I L'? iC' .1-i <br />7 r-..- -AL 4 VP\i14�:s I i:./ li E�..1 %r :� <br />RALPH <br />Fu !7 + xr� i <br />17 <br />cone PREVIOUS BALANCE BAL. OVER 60 DAY <br />L 16 4 4 • It 7 .� . LA IL1 • "� Js <br />CAL, A I'd 9 Sr']W ¢3 � L 1 � 3 dJ a� 3 C4 <br />BUSINESS <br />� TYPE <br />OUTER <br />CHAIN COUNTY - SVC. PIC PROD. P/C <br />j <br />CAL T N P�4. S � DIVISION � T L N <br />a6G311 S 1;$ ST PO :60Are 1+ 3C <br />LOCATION TAX EXEMPTION NO. <br />{ ids IVT 1: ® S T C K T U N CA 15206 <br />718 SLD 1 <br />=sC t tis CA 9 P I <br />HANDLING ASSOC. <br />SERVICE DATESALES N0. CUSTOMER P.O. NUMBER CUSTOMER PHONE# TAX CODE CODE CODE SERVICE TAX C.O.M.S. TAX PRODUCTTAX <br />DATE gRE�P <br />j y y <br />d �a wP j ie3� Jc t9 1-9 L01ti y�?"Yfl!°�`7813 rw5 1 {5-848f'" f w •7 f S �' <br />L6 <br />CHANGE CHANGE PROMO <br />SERVICE/ a L A L REMARKS/ SALES TOTAL WASTE SOLVENT/DRUMS SERVICE <br />QUAN. CHARGE CC SERVICE TERM SCH.DATE <br />MSDS <br />GIVEN <br />DEPT OD <br />PRODUCT [ rr UNIT PRICE TAX CHARGE MIN. CLEANSPENT #OE SK TERM (WEEKS)(INITIAL) DYwdl CODE! N0. � gg y )) <br />$kt {� '. �� CONT.. L 1:,. A aS I...° V • <br />�, �. (, � 9 - x. M� 4 5 L, �: 0� � e� 1 `314 1 � <br />q` - 4 :a. :1 ' Q 0 , _I <br />❑ <br />ll .Ij flA- C 01Q0-,. �.. 9 50 7,3 0 � 00 1 914.x, �4 <br />❑ <br />.9C d.l <br />¢ 3a)$ q 2 L 00 <br />❑ <br />El <br />1 <br />❑ <br />El <br />El <br />1 <br />El <br />El <br />El <br />El <br />t 7 i CHECK'F GOOD POOR YES NO YES NO <br />It •� • DECALS IN PLACE MACHINE PROPERLY GROUNDED <br />APPROPRIATE ❑ ❑ <br />TOTAL-SERVICE/PRODUCTS -. I MACHINE CONDR ON ❑ AND LEGIBLE <br />LOCAL PHONE N0. STICKER <br />BOXES & CLEANLINESS <br />Z <br />FUSIBLE LINK ❑ AFFIXED TO MACHINE ❑ <br />USEPA;TRANSPORTEFt 1 ID NO'• USEPpT�iANSPORTER 2;IC NO: <' GENERATOR USEPA ID NO' c„ GENERATOR,STATE ID'NO. , �` LAMP ASSEMBLY INsraueD <br />SPENT SOLVENT MEETS <br />❑ <br />W <br />- - - - - EMERGENCY CLOSING <br />...� L- - _ `'r ", CONDITIONOF LID UNOBSTRUCTED ACCEPTANCE CRITERIA ❑ <br />,1, { h.T t.., L13,C � 2501;73b HYi?�Q36L-J Q74 :� <br />0L1 : <br />-0 <br />@ .�..,,.. u93z! - <br />12. CONTAINERS 13. ;IOTA 14. UNIT � I CERTIFY THAT MY TOTA <br />11 US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID.) No S TYPE ANTITY WT OL SK DOT NUMBER g yy L, � t <br />:S 1J •.t � tJ � :;! WASTE STREAMS ARE WITHI <br />a <br />J <br />�g � p I �g (r,� p� p 1� ��y �y J, <br />` P� ,��,pp g �y t !� �g 8 a y�} p g„+ t LIQUID. <br />U S x- � LEA 9� N G' C `J JI P O U pV ,liar• � '4 �d •� � • � • Y.3 • Bpi B 1. I Q U J., D . i <br />