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AMERICAN ` TANK <br /> METAL Nbr/ 33493 <br /> RECYCLING, INC. TANK DISPOSAL FORM <br /> 2202 South Milliken Avenue Date: '19 <br /> Ontario, CA 91761 Job # gn <br /> (714)988-8000 <br /> R O. # <br /> CONTRACTOR: <br /> ADDRESS: <br /> JOB SITE: r / <br /> ADDRESS: <br /> DESTINATION: A.M.R. 2202 S. Milliken AVE., Ontario, CA 91761 <br /> DATE TIME PROJECTED TANKS ORDE <br /> 4 <br /> TIME IN: aai 11 - <br /> SPECIAL INSTRUCTIONS: JAN <br /> J <br /> N 2 9 1998 <br /> TIME OUT. dM <br /> � ENVIRONMENTAL F'- <br /> PERMIT/S1'RVIi -: <br /> r Services Rendered Cost <br /> — Disposal Fee 200.00 TANKS RECEIVED <br /> QTY. GALLONS TYPE NETTONS TOTAL <br /> Extensive Loading Time 150.00 F•S• <br /> Disposal Fee with Permit 300.00 280 El ❑ .14 <br /> 500 ❑ ❑ 21 <br /> Fiberglass Tank Disposal Fee Per Tank 400.00 550 El El .241000.12 ft. ❑ ❑ 44 <br /> 1000-6 fL ❑ ❑ .61 <br /> — Fiberglass Tank Delivered 2W00 1500 ❑ ❑ .87 <br /> 2000 ❑ ❑ .97 <br /> Bobtail Disposal Fee 250.00 2500 ❑ ❑ 1.14 <br /> 3000 ❑ ❑ 1.32 <br /> CaaG@4aUQR E" 25000 ___, 4000 El� 5000 Elia 1. 64 <br /> .6� <br /> 2.42 <br /> 2.84 <br /> TOTAL CHARGES $ r-m - 6050000 0 El 3.26 <br /> 8000 ❑ ❑ 3.44 <br /> All fees incurred are per load unless specified. 9000 ❑ E) 3'82 <br /> Terms are net 30 days from date of invoice. 10000 ❑ 114.33 <br /> 12000 ❑ ❑ 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 —STEEL 105 <br /> CERTIFICATE OF TANK DISPOSAL I DESTRUCTION <br /> THIS 15 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 /> AUTHORIZE <br /> GATE' S <br /> BILLING COPY <br />