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INVOfCE To----..... SITE LOCATION <br /> Cu5T6hmsa <br /> KA I. Associated Tractor r+u�ie Assoc. Tractor(Manifested) REPUBLIC <br /> ATTN. 34 N Ventura St SERVICES <br /> ADDnFss Agreement <br /> t�+ Customer Service !A ree <br /> 1323 W Charter Wy CITE Stockton GA g <br /> zipCCLIE 95203 AGREEMENT <br /> NUMBER <br /> crsv Stockton s�`=r CA Trr 'n(209) 898-4671 �Y fie, <br /> ACCOUMT NUMBER <br /> zrrewf: 95206 �Yrwaf+rztu Jen TrrLE CSS2 <br /> TEL W. (209) 466-3003 No, Larry Bvrelli (ITL <br /> E-MAIL Iborelli0l@gmail.com <br /> S,,,r N;MV ,r,B r na ,. La£dYd: 1 2.4 LEO yz"f, LYF MMrSF tA%".f;r Sift=SG Frau Lrf G7#� GF-tA rW?:fat rY.��i4.�t f <br /> Q <br /> RID IOYD f , . X F1A04 375.00 DEL 125.00 <br /> 0 <br /> 0 ' <br /> d <br /> 1 1 E' 4, i 1 E a ! ! 1 TAe tltldirsign tIEIrEEsar xtpela!p tkh AgFlameat,tlI Cy7tpFllal aetlGrdsEplslaa>u m a:ht had 1lIE aIE tlRElrlasnel the;;�� <br /> iflGns 81 1hf8 <br /> a HEMUNAt-rim REFaERRED 7t)AS Tr1E'COUP+INY- �W maGl s!Ire u IRI RIE Ibe avlhoallY ro;.r rslmaM rm OI a o!Cla�wnar, r <br /> ... Edy TITLE. <br /> 6v lilt[ ` r}a; St�rL4iLr� le / <br /> --- - —-----_ Cha��Cr <br /> j#LiJKYiiZkG S�CiN=F� <br /> K <br /> COMMENTS <br /> Manifested Disposal (tonnage) TERMS AND CONDITIONS <br /> ( nage)wilt be belled on a separate <br /> account through Forward,Inc. SERVICES. Customer grants to Company the exclusive right to collect and dispose of all of Customer's non- <br /> hazardous solitf waste materials (including recycraWes) (collectively, 'Waste Materials'), and Company agrees to <br /> furnish such services. <br /> t ��vpT+ <br /> TERM.M.�THE !g A f-r, �T�S[ e . ii E��� V,-_y:��;-[^IrND <br /> hRala based on tb . 13001YWYV w�L Aim TTu rTr�)IL}Ty M}�tl�17C�C13C�+ ���� �p'rCL""TrCYr'tyr�lTr�TTC��Y:'L�-RCr�CrT^i'l'Y!ry•I <br /> t Zc^ OFFICE USE NLY rYr C�LO4'CTR"ILRT'!"IArtFY-t3T"Y L-olir'1 <br /> • sTHE OTHER A 1;w1P OF THE TilF G411•'IT ENT-T.TE-R11+. ANY E OP <br /> DOES FACILITY HAVE A HAZARDOUS WASTE GENERATOR I.D. NUMBER? TE -+SEA tB GRE-FME --BSC S�AER 61 A6 Br' „Qrr'If�- N r r �ry�f <br /> I.Q I YES --;NO <br /> fit A1k�EP4R�tl�-FtE��ND AGT-UAB FRE6£IYE{�E3sF C'BMPAPFY NT S�Tr�Ctl <br /> NUMBER 1 <br /> WASTE MATERIALS. The Waste Materials shall not contain any hazardous materials,wastes or substances;toxic <br /> tusrOrEArWir, ria., t?uwt us ria 0kFD11 ALTs: substances,wastes or <br /> u. pollutants;contaminants:pollutants;Infectious wastes;medical wastes;or radioactive wastes <br /> } (collectively,"Excluded Waste"),each as defined by applicable federal,state or local laws or regulations(ColEecfively <br /> silt 9w3lfrr Lfr!Gn:1 Ate., axv ;„r yF,. ;: �• „ a swI uL 'Applicable Laws'). Customer shall indemnity, defend and hold harmless Companyfrom and against an and all <br /> gal y <br /> o::f `` claims, damages, suits, penalties, fines: remediation costs, and liabilities (including court costs and teaUuubte <br /> attorneys'fees)("collectively,'Losses")resulting from the inclusion of Excluded Waste in the Waste(Materials. <br /> S TraAlfp{1 5a;£y Af�1Ei ENT}trii '11.i Ugh '/,A ekE4frrKA:a'.J14iili TluJ2S„' <br /> 14011i[%ili mg Y90 <br /> TITLE. Company shall acquire title to Waste Matertals when Mey are loaded into Company's truck- Title to and <br /> HEAlW W14 d-jA1 w°f+=r;ai i? ak7Ea <br /> liability for any Excluded Waste shall remain with Customer and shall at no time pass to Company. <br /> carat�,l��, can�H�l;suh�Fkri3ET u�F: <br /> CONTINUED 4N REVERSE <br /> SLS 0T5(2081CA 12107 <br /> FILE COPY <br />