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Waste Management 1 llVl� 11L K1J 1 1V U. _ = <br /> Industrial Services, Inc. DAy <br /> 4501 California Court Phone(707)745-0501 TODAY'S DAT <br /> Belida,CA 94510 Fax(707)745-0510 W O# <br /> CwLTSTOMER 13 it �� _. CONTACT L b <br /> )Ib s o erl• -L <br /> T, <br /> UNrr P.O.# PROJECT CONTLETED YES OR NO, <br /> OB DESC: T&M BID 20K UNIT RATE CERTrP/1R CIRCLE ONE <br /> C k ( ~. _3a it t.T 3 t ROM i ice. i� 1 ri 'f{ �• -��!�" a l v A <br /> EMPLOYEE c+NMTa"0 B 1VS OFFICE USE ONLY <br /> INIT. CLASS I EMPL.#. LAST FrRST NAME START OUT STOP TOTAL TRAVEL ST OT DT TRAV <br /> : off r~ ` f �7 <br /> i <br /> INITIALS AFFIRM ACCURACY OF TIME AND NO UNREPORTED INJURIES OR INCIDENTS <br /> OFFICE USE ONLY OFFICE USE ONLY <br /> EQUIPMENT' QTY HRS COOFS I QUIl'MENT QTY HRS CODES ury <br /> K @—H/B PUMP# 2 WAY RADIOS 3041 <br /> _K® H/B PUMP# LEVEL ENSEMBLE R/D <br /> SAFETY HARNESS 3134 <br /> BBL.VAC TRK.# GAS METER <br /> TURBO-VAC# BLOWER <br /> GUZZLER# HIGH PRESS.HOSE 3083 <br /> C'AMFi.# "AIR/FIRE HOSE <br /> GEAR-TRUCK# "AIR/FIRE HOSE I <br /> GEAR TRUCK# 1"LOW PRESS.HOSE 3086 <br /> C-F.NL COMP# "VAC HOSE <br /> "FLEX LANCE "VAC HOSE <br /> "FLEX LANCE 12V LIGHT BULBS 3111 <br /> 30 MIN AIR PACK-SC'BA 3024 12V TRANSFORMER 3112 <br /> RESPIRATOR TYPE G.F.C.I. 3113 <br /> CARTSIDGES TYPE 12V LIGHTS 3114 <br /> DUCT TAPE 3166 M- DIAPH.PUMP <br /> VISQUEEN <br /> i <br /> NOTES _ <br /> �=o lL,. t L.G:{ C z: . ^:.i -6'r_ia 7 ] ,4 -zee z'& <br /> ' l <br /> By authorization of the time ticket the purchaser and his agent or representative agrees for the <br /> i purchases,to the f Rowing terms and conditions: <br /> �)Payment terms:net 30 days- <br /> ENTATIVE <br /> 12)In the event that collection and/or suit shalt become necessary to enforce the provisions of the <br /> i contraM or the paynu!nt due hereurkder,the contractor shall be entitled to add to the amount due for <br /> all collections fees CUSTOMER REPRESENTATPJE <br /> (3)15%Interest per month wilt be charged on accounts over 30 days.Annual percentage tate 1816. <br /> INvoic E <br />