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A96VIVIh li(—&hl Nu. <br /> jr,WW'N Waste Management <br /> Industrial Services, Inc. AY <br /> %AAwj <br /> 4501 California Court Phone(707)745-0501 TODAY'S DATE <br /> Benicia,CA 94510 Fax(707)745-0510 W / O# ' <br /> CUSTOMER-"T0SC-'-" IVJ`�&6-Tl,,16 CONTACT L `" As[ Le <br /> P.O.# PROJECT COMPLETED YES OR NO <br /> JOB DESC- T&M B11D 20K UNrr RATE CERT P/R (CIRCLE ONE <br /> -. 710.&1 <br /> 74> <br /> EMPLOYEE J LUNCHTMO B NB OFFICE USE ONLY <br /> ngrr CLASS ENTL.# LAST/FIRST NAME START OUT STOP TQTAL r TRAVEL ST OT DT TRAV <br /> I -A <br /> INITIALS AFFIRM ACCURACY OF TIME AND NO UNREPORTED INJURIES OR INCIDENTS OFFICE USE ONLY <br /> EQUIPNIENT QTY HRS OFFICE USE ONLY EQUIPMENT QTY HRS CODES <br /> CODES 2 WAY RADIOS 3041 <br /> @ Thi B'FUN4P LEVEL ENSETVBLE-R/D <br /> SAFETY HARNESS 3134EN <br /> BBL.VAC.TRK# 7 <br /> BBL.VAC.TRK-# GAS METER - <br /> BLOWER <br /> TURBO-VAC.# HIGH PRESS.HOSE 3083 <br /> GUZZLER# "AIR/FIREHOSE <br /> CAMEL# - <br /> "AIR/FIRE HOSE <br /> GEAR-TRUCK# <br /> GEAR TRUCK# 1"LOW PRESS.HOSE 3086 <br /> C.F.M.COMP# NAC HOSE <br /> "FLEX LANCE "VAC HOSE <br /> -"FLEX LANCE 12V LIGHT BULBS 3111 <br /> 30 NUN AIR PACK-SCBA 3029 12VTRANSFORMER 3112 <br /> RESPIRATOR TYPE G.F.C.I. 3113 <br /> CARTRIDGES TYPE ---- 12V LIGHTS 3114 <br /> DUCT TAPE 3166 M- DIAPH.PUNT <br /> VISQUEEN <br /> NOTES "Y <br /> By,authorization of the time ddKet the purdwser and his agent or representative agrees for the <br /> purchaser,,to the following terms and conditions: <br /> (1)Payment teats:net 30 days- WMIS REPRESENTATIVE <br /> (2)in dw event that wIlectim and or suit&W become necessary to enforce the provisim of the' <br /> contract.or the paymead due hereurider,the contractor d.a be entitled to add to the amount due far <br /> CUSTOMER REPRESENTATIVE <br /> all WIlections feeL <br /> (3)1.5%interest per month will be duwpd on accounts over 30 days.Annual percentage rate 1896. <br />