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LED CDlumbia, South Carolina 29201 I FOR SERVICE CALL .. W BRANCH MANAGER w DOC. EXP. SERVICE rERR°oR sa!7fi•5p eB. CUSTOMER NO. 209— 4 5 —uLS.aRA LP t T O R R i } . 02"t 24 2 G 4, 17 q v3 _ jj 1 C -I i� it ! J ! - FI I ds �- J RED CODE PREVIOUS BALANCE BAL. VV A, J e` ,-LvL PAI -LK %� U INJ. I`4 8 2-48isa,;tfes.` :its S .t. BUSINESS CHAIN COUNT, SVC. F(" ry PRc D. P,1:. O 14L , w i QC'KT:�FN AVL M -- 7? C ' '' � LOCATION TAX EXEMPTION NO. R RIPON t ` A iSi3166'"'k�k - 785ul �;rRVq € Dg,� i SALES W 4�1. j/' CUSTOMER P.O. NUMBER i CUSTOMER PHONE # TAX CODE HANouNc I Assoc. SERVICE TAX i r (I -M -S- TAY ; PRnr)i Ir.T TAY A. B. C. D. F - T- 9 7 SERVIL;E. I REMARKS/ =-, I - - - SALES QUAN. CHARGE_ TOTAL \N;?SIE SOLVENT%DRUMS SERVICE � �E— -�""N��',EE 001[ . rHvMO Go -SERVICE TERM iGN,0A1 - - mnq _PRODUCT 4 a I't L_ ;; UNIT PRICE TAX CHARGE MIN. CLEAN SPE Mr SK DOT M, LWEE,cs>ONrfU1L) m vM7 CODE } NO. L L. A S L „ j Q a c1rEly ". .,r.Y�i„i�L t.; L. -4-t- - " .. - _. f-riQlrl -- -- TOTAL-SERVICE/PRODUCTS e fl 91 f� I' - CHECK DECAL, IN PIALP i e• 4 PROPERLY GRO Yn `- 4 `--I ! o L u F. FCHINf F'R'PER U8DE0 APPRCPRwTE MACHINECONDT!ON ❑ ANGLCGICLE r= ❑ [P N6 LI _ SOXES &CLEANLINESS Loca Pr.DNENa.sn KER FUSIBLE LINK I -L• AFR%EC TO MACHINE � INSTALLED � ❑ USEPA TRANSPORTER 1 ID NO. USEPA TRANSPOR TER 2 I NO. GENERATOR, USEPA iD NO, GENF RATOR STATE ID NO. LAMP ASSEMBLY E3 El EMEPGENCY CLOSING SPENT SOLVENT MEETS - --- `.-�_-y' "t.� I CONDITION OF LID UNOBSTRUCTED ❑ ❑ ACCEPTAFICE CRITERIA �J I l 1 US DOT DESCRIPTION (INCLUDING PROPER SHIPPING NAME, HAZARD CLASS, AND ID.) 12. CONTAINERS 73. TOTAL 74. UNIT SK DOT NUMBER N TYPE QUANTITY Wi L I CERTIFY THAT MY "i GT. j� 3 ' �j WASTE STREAMS ARE WITIARS C) ;1 � + i I L R 1 DRAINED La L. N I - + OR S r` A L ] U L ?l F D) DE ,.{ Y' � tip- ONE OF THE FOLLOW. CATEGORIES. •"� 0 TO 220 LEIS_ MONTH ( Y 1 INRikLS 220 LBS. LWr.,ML-cn -. __ -- /Tjr2:2 LLI GREATER THAN 2.900 IWjMONlH _-_ I i t'xn to INITIALS _ V: O DESIGNATED FADELITY NAME AND ADDRESS SAFETY -K L E E N 3 Y E'T E N S • INC. I CERTIFY THAT NO MATERIAL CHANGE HAS OCCURREDUSA EPA ID _ NO. C+� TO iis , s. I z n _ _ _ _ 'au -SG A $ �� 6L.Vi; 3 _ H EITHER IN THE CHARACTERISTICS OF THE WASTE „4 ,-� MATERIALS OR IN THE PROCESS GENERATING THE STATE ID NO. It- A 0 L II E7 0.1 _ ?�'.��, �1 Q,; I W _ .tiF . WASTE MATERIALS. � CASH TOTAL RECEIVED APPLY PAYMENT TO: MANIFEST NO. I AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TERMS AND TOTAL CHARGE - - - CHECK NUMBER ❑ i, TODAYS SERVICE/SALE A x A is CONDITIONS SEI FORTH ADOVE AND ON THE REVERSE SIDE OF THIS DOCUMENT. (FROM ABOVE) PLEASE CHARGE MY ACCOUNT FOR THIS TRANSACTION UNLESS OTHERWISE - i cr y. "A ❑ PREVIOUS BALANCE AS FOLLO'NS I I`�T LDR MESSAGE INDICATED IN THE PAYMENT RECEIVED SECTION. THE INDIVIDUAL SIGNING THIS DOCUMENT IS DULY AUTHORIZED TO SIGN AI:D BIND CUSTOMER TO ITS TERMS WASTE MIN. (FP.OM ABOVE ) E710 Q' Qf- INVOICE - AMOUNT$ � --! IVJOICE# AMOUNT$ [DR - - N t�"EQ 'Th!s Is W cerWS d� We eoove+�emed m.wedals ar^ f operty cbs:ifiad. p k wd, madretl and J,L tl-A. and am D pnperrs.�Saq+.iy .nooanrwn Ir,plovwecq�wro�bnon.W+nawrerm=avolTansAan:wn�TOT _ _ in I I i ! PREVIOUo r ... _ . i -REDI I I _ - MANIFEST 1 CODE SEQ s # d I _ Y/SA DO NOT WRITE IN THE AREA SCLOW ..^•ARD yQ—,-- I -- _ --_-- CR DT AR O. —` i\! L Pri t Customerme �f 0024 0 � 9 Rc By: r�a -4 u c C c - 3 7 i - a Lt, = -T-T--r-T- CLsmers AuthorizedRepresentative IINFOPM.ATION I I I I i I I i I I I I I 1 I I '+ I '' I THI.Q AGREEMENT rf1NTIN11 iFC nN THF RFVFRQr Rini=