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iCPG # TO: ON..,oCE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL co <br /> ACCOUNT NO. �DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST AKA FIRST MI TITLE <br /> DURATEC <br /> C/O NAME GUARANTOR <br /> , SSN 1, <br /> GARY J DURAN I I I <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> DURATEC P.O. BOX 1207 MANTECA CA 95336 209-858-8359 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1022 SWAN DRIVE MANTECA CA 95337 209-858-5359 <br /> FRL)b <br /> USER REFERENCE NO. [BILL bTAT ICYCLE ISTATUS DATE I BM d CBM d IMONTHLY PAY AMT �Y!�'J:w TERM DAT& <br /> 542 HAZMAT 1.2/29112 1 1 1 <br /> L;kUU',UZb <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USERREFERENCE <br /> _Q13 <br /> f I I F 11 4-_1 <br /> SERVICED -DATE OF <br /> FSTART 'MED RECNO CHARGE <br /> TA <br /> CHARGE DE'PT'.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NR <br /> 2 0 <br /> 30 042000.0 2012 Hazmat Fee $96.00 <br /> TOTAL $96.00 <br /> GUARANTOR <br /> nQR np i ir.mn <br /> PRIOR STREET IT 71P CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> DURATEC 209-858-8359 <br /> EMPLOYERSTREET CITY :sj�ZIP COD <br /> 293 E WETMORE ST MANTECA CA 195337 <br /> CO—OWNBIA <br /> AST FIRST MI TITLEJ SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> L I I I I I I I I I I I I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> DURATEC 209-858-8359 <br /> EMPLOYERSTREET CITY qT 71P ConP <br /> 293 E WETMORE STM NTE CA 95337 <br /> PRFPARFn RY I CHECKED BY IDATE COL. M(gee) <br />