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A <br />U1191 BOU&JT SERVICE <br />TUFMCK, <br />CA 95381 <br />goo 253-2 <br />P.O.6 256 <br />209 66&8908 - <br />209 6688909 FAX <br />"Your Central California Antifreeze Recycling COmPany <br />Order No. <br />Invoice No. <br />Company 7i. <br />zip <br />Address State <br />City — Fax <br />Phone Dale of Service <br />Contact <br />GALLONS BEFORE SERVICE <br />SERVICE 'f _ 4 <br />AFTER @ _L ---- 4_�' <br />GALLONS CE <br />ONS SERVICED <br />TOTAL GALL <br />------- <br />GALLONS OF ANTI FREEZE ADDED @ <br />@ <br />---------- <br />@ <br />NON TAXABLE <br />TAXABLE <br />j/1 SALES TAX <br />e TOTAL <br />FREEZE POINT <br />Ph <br />Y_ <br />BEFORE: <br />AFTER: <br />-TED By' Date ------- <br />RECEIVED <br />AC�f P <br />r, <br />METHOF Pq,40* cOARGF,pO#PO# <br />CASH / CK # eUVMffJ39,EZE <br />N—AR—R—ANTI—YED"PECT" I from the manuiecturer ot the recycling <br />L-1 M-1 - r 9 VD, . bacl(ed by a Wal .-- recycling. Warranty M10""allon is <br />Coolant Service 's first from the d�te ot <br />The anittreeze recycled by California roomes <br />chemicals for (2) yea, or 24,000 Miles - V'hiC*\e <br />available upon request - <br />1. Please send -copies of your invoice. <br />2. Order is to be entered in accordance with prices, delivery <br />and specifications shown above. <br />3 Notify us immediately if you are unable to ship as specified. <br />4. Our order number must appear on all invoices, packages <br />and correspondence. <br />DUPLICATE <br />AUTHORIZED BY: <br />