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LOCATE;:N ! r ��� -
<br /> ��'t .7PFD03 74
<br /> 4001 N- Vasco Road U }-(_fa __, ���tom= PLEASE REMIT TO
<br /> 1Avcrmorc,CA 94551 :�i - -- P_O. Box 83328
<br /> (925)447-0972 l — .� �= gz -r: .� Portland,OR 97203
<br /> �.. Y� WASTE RECOVERY WEST. INC. Q
<br /> Fax 925 456-7794 I� _0S 1-877 OLD-TYRE.
<br /> I�IF1Jntcr [-1(;cncraEor ( �3inJ Usc Facility tv!
<br /> Invoice Date fi `6/�-' _ Load Date �0L.? k"P
<br /> Phony qr �� 6� �J!)c livery
<br /> Customer Name 6V6ePL1- -Lu-�l7--,—✓f/.C•ity-L-�-!
<br /> Acct#_
<br /> Site Street Address6'41$LY 4A4V98J_ - pJS
<br /> 2.3
<br /> State�� Zip
<br /> DRIVER I crrtify,h,...... wnalry„i h<r ,y ,,h.,,hr lr rrh<.rra<r,rcahh.r„ia th„tha inr,r
<br /> ,,.art that falaihcatinn,diAss inGnmawnn may roult on a .ac-of
<br /> I>c ri UI rca.In uldnwr,,I an
<br /> uvil Po'an,rcvoruior,,a denul oT renawal or the Nhsrt lire lf,ulrr Ko
<br /> op,Hcsnurccs fak acctwn�2M0 and nuy.nuh m nn! cnaltic,a to 25 6ssttation is, m
<br /> r r S ,000 Pct.fay,Per wulm,rsn ur admmiatrarivc P<nahirs u to SS,1N10
<br /> i2W,2. -- --- _ - _ --- _--- P _ for'
<br /> -- na„I<r r•.,rn,Pr.,.n �jt:,,�rrrr.,,�„� I tl.hn
<br /> TRUCK I A LER TRLR LGTH rRLR J' ER/H L R I IA,;.k uhme f il'�rnnv
<br /> (J (�� MANIfESi! CA$H/ IAgG[,r
<br /> OECALI LIC STATE IMPORT
<br /> fj•/"� r 5���22� �qr LOCATION CUSTOMER rPIDor TRIP
<br /> EAPORTI LOG
<br /> LOAD AMOUNT
<br /> OUANTfTY Description LOAD TYPE
<br /> c-T-r-P Rate Amount
<br /> ------------
<br /> Customer Signature
<br /> Total Amount It y }e
<br /> �/ I<uuly flus uualar ,cu 6 r i J6
<br /> I + Y • Icr ury uwlcr rlw lawn of rl.c har<ul r.,lstonw dus slw mbnmai nas I,n sndal,hswc rs tnsr an.f
<br /> _ rnrrrcr.In adrimon,I am awuc t�ur CaTas-niuu s,t shin mfr,rrsaasion nu r auir n,civil wn,lec C 2962
<br /> a.......nfive Iwnaluea up su$5,000 twr,v1�.4riem Prr.lay as deurd.r.l asn I'ublw Itrww,n rs tulJer srctw,«42 M1r`,1r Y'Prr vinl,tusp INVOICE —L
<br /> 90- d d95 : ZI 90-£O-UPC
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