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A. 4. C. D. Co;unTbia, South Carolina 29201 - MACE?�, FOR SERVICE CALL - BRANCH MANAGER DOC. EXP. SCHFDULED SCHEDULED SERVICE WEEK TERRITORY a%Tp.l:5:9- CUSTOMER N0. ---�--� -; — �-� ?C��? -, �, s `1 1 281111 TORRES 03; 8/03 03.-02 v'4 002 264 0 t • 7 c.CoopREorr PREVIOUS BALANCE rn _ — B 55127. 59 903, y.e .. L _ t RIVER PAPER CO3 — RIPON r,; BUSINESS nre CHAIN OUTER COUNTY SVC. P/C PRO.D. illO C 9 10000 o 1 _ 79,11__a. 42yTO4.xON Ayre' LOCATION TAY. EXEMPT!0N, f%O. A.111 T'-! ACCTS PAYABLE -----__ 71.85 � l CA r�5366-278471.8501 1 _ �- ,E •�^.u J'_ SAfI ! CUSTOMER P.O. NUMBERCODE CUSTOMERPHONE # HANDLING TAX CODECODE -�" ASSOC. CODE SERVIC}E TAX C. 0. M.S. TAX 1 PRODI,-T TAX S5 12,09-599-4241 05--3.9-5--7209 - 07 - _ SERVICE:/ SURVEY R F-Ht�VIA f r DEPT DUAN. SALES TOTAL WASTE SOLVENT/DRUMS CHARGE SERVICE CHANGE Gn .Ge PROMO, CC SERVICE TERM SC L IATL MSDS PRODUCT r � ,; -OMIT TIPEy � TAX CHARGE a of MIN. LEAN SPENT ool+r SK DOT TERM CODE EEKS flN1TIAL m YA4 R 1 L E A S � �f } GIVEN C n c1{. 100001 14. 900c 0 o L. --� -- n El . - - , _�- ., - n �-. I QTAL-S ERVI C ETRO DUCTS I G{r' CHECK GOOD POOR YE NO DECALS iN PLNL'E MACHINE PROPERLY GROUtIDEP ❑ ❑ YES NO ❑ ,. 1 I MACHI!k CONDITION Ai9L`lEf•IBU: ❑ ❑ LOCF_ PHONE NO. STICKER z _ I FOXES &CLEAt7UNFSS FJSIBLE LINK :NSTALLE[) ❑ CI AFFORD TO MACH'NE I 'PORTER 10 NO. GENERATOR USEPA ID NO. GENERATOR STATE ID fd0. 'j � I G (� _ SEPA RAf 1 N JS F.'1 TRANSPORTER ISPO RTER 2 ID I LAMP ASSEMBLY ❑ ❑ SpINTaOLV[NTM MEETS aMERGENOY CLOSING F--� I _; s� —I I - - . , y-} y �- 1 OF UD UN05S mUCTE"r ACCEPTANCE CP.i iERIA (✓ c[ C. ""o C! 1t LJ 13 91 t !t' -- - T S DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME. HAZARD 171r]!'}N N •2.CUNfAINERS 13. TOTAL j14.UNIT SK DOT NUMBERfr cs ICEFTrY r.;.a'r MY TIs- N'. TPE QUA Y Wr '5 WASTE STREAMS ARE DTALLUCE WITHIN ` - - O I/-"j�... p/J1 [ O.'[E OF THE PJLLOW:NG % /1 1 C-y� ( CATEGORIES. �]�a�r�1 } n } J i, I i i 1- OTO'?�O tbS.:'MONTTi e !r �---•- -- - - ---- - �-iecel l LLate t= 8'5 j PO. No. f 85© �' --__ _j _. ` - 1 INITU.L.S: � I ! � = 1 —1- 2 O.LBSS. TO2. SO. I Line iib. INiTULG - - I Receiptoc. GREATERTHAN 200L3S/hIONIH �:'r�t,nrr�ri Qar � • j J wrr.;�L� � c DESIGNATED FACILITY NAME AND ADDRESS _ I CERT: Y MAT NO MATERIAL CHANGE HAS OCCURRED IDSA EPA ID NO. I 1 _ v CASH ❑ TOTAL RECEIVED ADPL PAYMENT TO: s ;:z y z %' EITHER IN THE CHARACTEPISTICS OF THE WASTE MATERIALS OR IN THE PROCESS GENERATING THE STATE ID NO. WASTE MATERULLS. I AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TERMS AND TOTAL CHARGE CONDITIONS SET FORTH. ABOVE AND ON THE REVERSE SIDE OF THIS DOCUMENT. (FROM ABOVE) PLEASE CHARGE MY ACCOUNT FOR THIS TRANSACTION UNLESS OTHERWISE - -- _J .- v LL (� °Y '+ CHFrK NUMBER - - - r ❑ TGDAY'SSERVICFJSAIE r a.Ii I ❑ PRFWUS SALNNCE AS tOLLOW3MESSAGE INDICATED IN THE PAYMENT RECEIVED SECTION. THE INDIVIDUALSIGNING THIS WASTE DOCUMENT IS DULY AUT,iORIZED TO SIGN AND BIND CUSTOMER TOOITS TERMS. (FROM ABOVE) � -Ras % b cer:ily Nat Mu ala --mad malx.ah am naPaM damrfiM. ptcAa3etl, meMaC ab Iabded, arae am :r, PmFa maa w a a pa mpaa•aaao el r,� aPaa abb,a,,,�tlaaa a eEPa maa:alT a�aaAa o • � TOTI AI DUE � / A y� `yi' —�L— d I Y LDR ME :SAGE ^ Irr cic � T>t AMOUNT $ INVOICE 4 ; AMOUNT $ 1 s 1: R t�; O REQ ' L� ` ! ANhFEST C E SEO # • "REA IS _.. _.—_ .._...__� .. . - -- JH- 1:T !. __.-.._._...d--...--__ _,.. CAR_NC ~� r—.- — —.- UREA: 'GaRD NO. --- —'- r P. .AMEATE t / f %N( Y�.-" DO.t_)TWillI < IHEARE BELOW Print CustoName mey i VISAX MC OF EMERGENCY CALL Customer'sAuthoriied Representative !NFOTRMAT:ON j ; ! j i + j j i j j j j I ( j iG:IrDSI7:51[YrIYIITIrrF11! THIG A(-,RFFMFNT (-ONTINI IFR nN THF RFVFRSF RIfTF