Laserfiche WebLink
Ak <br />• <br />P.O. Box 481 Benicia, CA 94510 <br />(800) 479-7993 <br />Big ter <br />Filter Recycling • Tire Disposal <br />Waste Oil/Antifreeze Recycling <br />is EPA # CAL 000301639 <br />CA II 1463691-01 <br />Bill of Lading NO <br />Date ?: ?:6 <br />• PLEASE PAY FROM THIS INVOICE • <br />QTY <br />Nfi^TIRE <br />RECYCLING FEE ACCOUNT NUMBER (IF APPLICABLE) <br />AMOUNT <br />DRIVER TRUCK n <br />C <br />t <br />55 GALLON DRUMS of USED OIL & GASOLINE FILTERS <br />U <br />Lk ge-1 1 <br />T <br />CASH <br />S <br />E <br />ADDRE So e <br />BILLING ADDRESS (IF DIFFERENT) <br />O <br />� ✓� Gyr�` <br />vJ <br />R <br />NET 10 DAY <br />M <br />E <br />S <br />S TE ZIP PHONE <br />CITY STATE IP <br />USED MOTORCYCLE TIRES FOR DISPOSAL <br />R <br />USED AUTO TIRES FOR DISPOSAL <br />PO <br />USED LIGHT TRUCK TIRES FOR DISPOSAL <br />• PLEASE PAY FROM THIS INVOICE • <br />QTY <br />PRODUCT <br />RATE <br />AMOUNT <br />Off F' ter Recycfing <br />55 GALLON DRUMS of USED OIL & GASOLINE FILTERS <br />SET UP FEE(S) <br />Tire ecyc ' g/ isosal <br />WASTE TIRE MANIFEST # <br />USED MOTORCYCLE TIRES FOR DISPOSAL <br />USED AUTO TIRES FOR DISPOSAL <br />USED LIGHT TRUCK TIRES FOR DISPOSAL <br />USED TRUCK TIRES FOR DISPOSAL <br />USED TIRES ON RIMS <br />USED FORKLIFT WHEELS FOR DISPOSAL <br />27 FT. VAN: TIRE DISPOSAL <br />C I W M B ADMINISTRATION FEE <br />FUEL SURCHARGE <br />Other services <br />DRUM SETUP/PICK-UP METAL/POLYZE /1 3 /45 <br />USED BATTERY PICK-UP <br />SOLID WASTE (NON HAZ) <br />MINMUM CHARGE $ 50.00 <br />I certify amount sho . . - ofDe correct <br />(DRIVER SIGNATURES 1i TOMER SIGNATURE) <br />PAYMENT DUE UPON RECEIPT OF INVOICE. fA.service charge of 1t/% per month shall be TOTAL CHARGES <br />j <br />cnargea pn all past aue accournL. In t event mis account Decomes aeunquem anu is necessary <br />to instituite legal proceedings, customer agrees to pay reasonable attorney's fees and court costs. <br />I <br />IVFIITE: Customer CANARY: Accounting PINK: Tracking <br />_:e! N<,::o. <br />