Laserfiche WebLink
09;'3012010 10:52 12093341873 FLAGCITV CHEVRON PAGE 04104 <br />Snn,Jo"wn Co, Kmw <br />7950 South R.A. Orldgailia St CRSQG DATA SHEET & WAIVER <br />3tovktan, CA 86208 <br />T4 tlnphons (209) 468-SR70 ,10E; <br />Fax:(MS) 468-6672. <br />SAODW48 <br />M1*Vh3"V0ivW <br />8Mr9 And lk d -M nnrarawn mmw 0" mm the (*se or oneor ++�t3tB 00110010 programs to Mose businese" that <br />90116d lean theca 100 Idl mms (29 aallona 61,220 pow0n) of h=011woaa sante, per month. 13tame3ees [het generate rmm <br />them this emormt are rami Md by 1aw to uae a lidenaed hw2(dM4a waste hauler to manitontanti haneport tbelr waste. Ther ftm, <br />In oder to patliatpate In Us ptoptem you must slQn the f0g=1110 washrer Of 0111@y, !Ate vasenm Ma right to navtew Your annual <br />mrinllbsM or consult VOM the C opyq gvtronme i tipah r5wirimnt to detarmlae yolrr ellgINJIty fbr uea of this prognAm. <br />Thank you. <br />I IDOMIy "tlualnean trill i arts raptr entina is a Condltlonatly Elempt SmpII IQu tntittr ONitrAW (CESOG) who panpmtam no <br />more than 100 Idlorame (27 R84onS or 220 ptrilnda) of (SWr t0Us WOMte per MOM11 based an an annual overs a and I, the <br />reprasmnattve of the CI WG, undwatsind the maximum yuan*y of "nate, ecoeptod at the 11M tar dlneppaaseaat Is 27 gallons or 220 <br />pourdle end slily dlopos81 cable chased anal[ be the mapoost1lKlity of ther CFSQO (o pay at the !tare of dispasal. <br />00 NaT WRITE BELOW THIS LINE <br />INVNTr,RY <br />(To pn aomplawd by mllsoeon palsonno ,� <br />