Laserfiche WebLink
AMERICAN FUEL TANK <br /> METAL `. Wv0 3 3 4 9 3 <br /> RECYCLING, W i,; ANK DISPOSAL FORM <br /> ,. <br /> 2202 South Milliken Avenuet `� F r 1 19 <br /> Ontario, CA 91761 JAN 2 6 TM" Job a <br /> go <br /> (7ta) 9N-8000 <br /> ENVIRONMENTAL HENLOh# <br /> CONTRACTOR: <br /> STocKTQN Ggo�� Tic <br /> ADDRESS: <br /> JOB SITE: <br /> ADDRESS: rino <br /> rJ-t ,>tZ 12A. i <br /> DESTINATION: A.M.R. 2202 S. Milliken Ave., Ontario, CA 91761 <br /> DATE TIME PROJECTED TANKS ORDEREOBY: LIC NO. <br /> TIME IN: <br /> SPECIAL INSTRUCTIONS: <br /> �^�/ --- -- TIME OUT <br /> �M!Y I�i�eJ15 TL 'e4'W <br /> r Services Rendered Cost <br /> Disposal Fee 200.00 TANKS RECEIVED <br /> OTY. GALLONS TYPE NET TONS TOTAL <br /> Extensive Loading Time 150.00 F-S' <br /> Disposal Fee with Permit 300.00 _ _ 2580 O O .21 <br /> _— 550 ❑ ❑ .24 <br /> Fiberglass Tank Disposal Fee Per Tank 400.00 _____ 1000.12 n. ❑ ❑ .44 <br /> _ 1000-6 ft. ❑ ❑ .61 <br /> — Fiberglass Tank Delivered 200.00 ------ 1500 ❑ ❑ s7 <br /> -------- 2000 ❑ n .97 <br /> Bobtail Disposal Fee 250.00 ---- 2500 n ❑ 1.14 <br /> 3000 ❑ ❑ 1.32 <br /> _— — 4000 ❑ Ax. 1.64 <br /> 5000 ❑ n 2.42 y <br /> 6000 Cl n 2.84 <br /> TOTAL CHARGES $ -egp 75DO 11 ❑ 326 <br /> 80DO ❑ ❑ 3.44 <br /> __ _ _ <br /> All fees incurred are per load unless specified. 9000 Ll 11 3.82_ _ 10000 ❑ n 4.33 <br /> Terms are net 30 days from date of Invoice. 12000 L7 n 4.93 <br /> Contractor's signature represents acceptance <br /> Of terms for payment,and confirms that tank NO.OF TANKS TOTAL NET TONS <br /> removal complies with State laws. <br /> CONTRACTOR'S SIGNATURE 'F — FIBERGLASS S —STEEL 105 <br /> CERTIFICATE OF TANK DISPOSAL I DESTRUCTION <br /> THIS IS TO CERTIFY THE RECEIPT AND ACCEPTANCE OF THE TANK(S)AS SPECIFIED ABOVE,ALL MATERIALS SPECIFIED <br /> HAVE BEEN COMPLETELY DESTROYED FOR SCRAP PURPOSES ONLY. <br /> AUTHORIZED CrATE <br /> CONTRACTOR COPY <br /> IfU-40,1 t III�orc 41A" I I , anr,o alj�,10,111t <br /> I <br /> i P . <br />