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n� <br /> �Nv11rtO <br /> DM <br /> -r T1114rd Envixonmenial Se v'CC6EC 9 2005 <br /> PO Box 579 3474 <br /> Byron, CA 94514 <br /> Telephone No (925) 634-6850 <br /> Facsimile No (925) 634-0569 � <br /> Date [� JOB NUMBERS) JOB NUMBERS) JOB NUMBERS(S) JOB NUMBERS(S) 1 <br /> TRUCK CGS TRAILER # # # # <br /> NO D NO <br /> SUB # # # # <br /> HAULER <br /> PRIME <br /> CONSIGNEE <br /> CARRIER I { <br /> GENERATOR{S) DESTINATION4C6 U� c—z7 <br /> CITY <br /> L <br /> CITY BEGI 1 MI GE� EN 1N ILS <br /> MATERIALS LOADING UNLOADING FUEL-GALLONS FUEL-VENDOR <br /> #1 #2 #1 #2 <br /> MANIFEST YARDSOR TIME TIME TIME TIME <br /> NO NO WEIGHT ARRIVE LEAVE ARRIVE LEAVE <br /> 2 <br /> 3 OFF SE ONLY <br /> a TNSI YIRSI DS YDS <br /> e <br /> 5 TRANSPORTATION UNITS <br /> 6 TRANSPORTATION RATE <br /> 7 SUBTOTAL: $ <br /> 8 <br /> 9 DISPOSAL UNITS <br /> 10 DISPOSAL RATE <br /> 11 SUBTOTAL: $ <br /> 12 <br /> 13 BRIDGE-TOLL <br /> COMMENTS <br /> tib) MATERIALS <br /> t <br /> 11 L <br /> ST <br /> Isrp DEDUCTZ NET .r�r TIMEDEO TIME <br /> DR <br /> RIECEMD DA'T'E APPROVED BY TOTAL CHARGES: � <br /> TERMS and CONDITIONS <br /> Payment terms are net thirty(30)days subject to a charge of 1 5%per month on al!past due balances In the event the account becomes delinquent and itis necessary to institute <br /> legal proceedings CtiSTOME"R agrees to pay DES attorney s fees incurred in such proceeding action or suit or in any appaal thereon The parties agree that actions or <br /> proceedings arising in connection with this agreement shall be tried and litigated exclusively in the courts located In Contra Costa County California <br />