Laserfiche WebLink
ff Universal <br /> 28872 <br /> Environmental, Inc. <br /> 4101 Industrial Way P O Box 996 Benicia, CA 94510 707-747-6699 <br /> HAZARDOUS WASTE HAULING REMEDIATION INDUSTRIAL CLEANING <br /> ' DISC 3240 zICC# MC271664 <br /> MANIFEST# (�gfk#j DATE — <br /> PO # <br /> CONTACT JOB# Z <br /> CUSTOMER d <br /> JOB LOCATION <br /> CITY �L<]`T= STATE 4WSERVICES PERFORMED <br /> 1 DELIVER BIN# <br /> PICK UP BIN# <br /> PRODUCT V ORIGIN DESTINATION <br /> ARRIVE JOB 6'I ,S`/,S� Q— RIVE DISPOSAL 3 <br /> 9DEPART JOB Q S( a � """ EPART DISPOSAL Rf X030 J A <br /> tTRUCK# &d?: RAILER# �Q� START pp STOP ME <br /> CAPACITY TIME OUT TO LESS HOUR <br /> # LOADS DM/YD/LBS/ LINER 1y2 W/O NET HOUR <br /> ' DISPOSAL S ef* PER DIEM TOLL <br /> DRIVERS NAMELABORER <br /> ( I -,f 4�alljl7ojl�l '-/X <br /> ER5 SIGNATURE STO ER AU ZATION <br /> NOTE In the event of action or proceeding upon this agreement the court shall award to the prevailing party court costs and resonable attorney fees <br /> Interest will be charged at the rate of 1 1/2%per month 18%per annum on all overdue accounts _ <br />