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<br />Plano, Texas 75024 www.safely-kltpii.com
<br />AMP
<br />CUSTOMER NO.
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<br />SERVICE DATA SALES REP NO CUSTOMER P.O. NUMBER ;
<br />_ vv,v., •�.+• �u-aa. vaa• YLU. IV IYW JGWOVV Ii
<br />FOR SERVICE CAUL BRANCH MANAGER DOC, EXP. SO SCHEDULED
<br />£ERYir.X:FWFD FK I T9RRITQRY
<br />F:Vt!_PH TORRE.S pl,
<br />ry ��55 CREDIT I PREVIOUS BALANCE
<br />I�j1i1���!^"•�+CJG7:•'�S CODEIIIIIIIIIIIIIIIIIIES,
<br />NOW i.rL.l`* RS USTOtAE CFLAIN OUTER
<br />'� L"1 i C SEGtl 4. "H q COUNTY
<br />PO BOX 1S 9
<br />STOCK IFIN Care ':375i:.01 4; TA
<br />TAX I C.O.M.S.TAX I PFiODUCi TAX
<br />SERVICE/
<br />DEPT
<br />L� • ' ra ' ' REMARKS!
<br />QUAN' CHARGE
<br />E Illi�lA'g" I PRICE
<br />SALES TOTAL
<br />TAX HA ,E
<br />WASTE
<br />MIN.
<br />PUT
<br />UNIT r,'. ,.
<br />CONDITIONS SET FORTH ABOVE AND ON TI IC RCVCnSE SIDE OF )HI.•: NOCUMENT.
<br />PLEASE CHARGE MY ACCOUNT FOR THIS TRAN9ACTION UNLESS OTHERWISE
<br />INDICATED IN THE PAYMENT REL:LIVEU SECTION. THE INDIVIDUAL $XINING THIS
<br />DOCUMENT IB OULY AUTI IOnaco TO SIGN AND GINO CVMMER TO ITS TERMS.
<br />C)
<br />B�AL VER fi0 UAB
<br />—�
<br />--
<br />SVC. P!C PROD. PIC
<br />O
<br />VO LBS. '2.200 LBSJMONTH
<br />— IMMALS
<br />TOTAL DUE `".
<br />UO NOTWRiTCI' M,RRC
<br />i } '" !• "' ;F
<br />17th+j�9r.'?....,i��< o .l. ! ' ':�1'I
<br />SEE) ,Y
<br />8
<br />EXEMPTION NO,
<br />7
<br />2
<br />G4. AIFH MAN 2,200 LBS..TAONTH
<br />5
<br />6
<br />7
<br />8
<br />12 J .�c )
<br />TOTAL-SERVICE/PRODUCTS
<br />U E� T �,LJ NO. USEPA TRANSPORTER 2 ID NO. P - WE 7 PA Q GENERATOR STATE IS
<br />A
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<br />D.
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<br />w •'- ` -' •'• . Y CATEGORIES.
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<br />0 TO <'PO LB6.rM0rJTH
<br />2
<br />CASH R I TOTAL RECEIVED
<br />PREVIOUS
<br />i CREDIT
<br />SACRAMENTO
<br />APPLY PAYMENT TO:
<br />❑ TODAY'S SI.HVLCQ.lALE I`{
<br />❑ PREVIOUS BALANCE AS rCLLO'1i3
<br />INVOICE III AMUUN i S L
<br />MANI
<br />LIMCLII t AMU tvU• AMEX
<br />EFI] Mc VISA
<br />CUSTOMER REFERENCE
<br />WASTE MATERIALS.-
<br />I AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TC:Rds AND
<br />TOTAL CHARGE
<br />S
<br />)•
<br />.,m.
<br />CONDITIONS SET FORTH ABOVE AND ON TI IC RCVCnSE SIDE OF )HI.•: NOCUMENT.
<br />PLEASE CHARGE MY ACCOUNT FOR THIS TRAN9ACTION UNLESS OTHERWISE
<br />INDICATED IN THE PAYMENT REL:LIVEU SECTION. THE INDIVIDUAL $XINING THIS
<br />DOCUMENT IB OULY AUTI IOnaco TO SIGN AND GINO CVMMER TO ITS TERMS.
<br />C)
<br />B�AL VER fi0 UAB
<br />—�
<br />--
<br />SVC. P!C PROD. PIC
<br />O
<br />VO LBS. '2.200 LBSJMONTH
<br />— IMMALS
<br />TOTAL DUE `".
<br />UO NOTWRiTCI' M,RRC
<br />i } '" !• "' ;F
<br />17th+j�9r.'?....,i��< o .l. ! ' ':�1'I
<br />SEE) ,Y
<br />8
<br />EXEMPTION NO,
<br />- _ _. _ , .. a. ..,. .�. .. .
<br />• �... ` y a. .e. u - .a...ay r �.• s L w.,. , . v e 7T. -.Tr z-c:r a�-1 t . + a.. s�.a tia- e
<br />w •'- ` -' •'• . Y CATEGORIES.
<br />sfYt_r.Pl;✓:tiE/4 1 I.ID#E t3$.li! �aC f T?: tEiF?t1�t1.i:�)r"C�� y ri17117,17,, no:-29� D--1Wi.rq E? 4 t ��, c
<br />0 TO <'PO LB6.rM0rJTH
<br />2
<br />CASH R I TOTAL RECEIVED
<br />PREVIOUS
<br />i CREDIT
<br />SACRAMENTO
<br />APPLY PAYMENT TO:
<br />❑ TODAY'S SI.HVLCQ.lALE I`{
<br />❑ PREVIOUS BALANCE AS rCLLO'1i3
<br />INVOICE III AMUUN i S L
<br />MANI
<br />LIMCLII t AMU tvU• AMEX
<br />EFI] Mc VISA
<br />CUSTOMER REFERENCE
<br />WASTE MATERIALS.-
<br />I AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TC:Rds AND
<br />TOTAL CHARGE
<br />)•
<br />.,m.
<br />CONDITIONS SET FORTH ABOVE AND ON TI IC RCVCnSE SIDE OF )HI.•: NOCUMENT.
<br />PLEASE CHARGE MY ACCOUNT FOR THIS TRAN9ACTION UNLESS OTHERWISE
<br />INDICATED IN THE PAYMENT REL:LIVEU SECTION. THE INDIVIDUAL $XINING THIS
<br />DOCUMENT IB OULY AUTI IOnaco TO SIGN AND GINO CVMMER TO ITS TERMS.
<br />(FRAM ABOVE)
<br />INITIALS
<br />(Z)
<br />t" (9
<br />� 0)
<br />VO LBS. '2.200 LBSJMONTH
<br />— IMMALS
<br />TOTAL DUE `".
<br />UO NOTWRiTCI' M,RRC
<br />i } '" !• "' ;F
<br />17th+j�9r.'?....,i��< o .l. ! ' ':�1'I
<br />SEE) ,Y
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<br />Print Customer Name / 1
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<br />7
<br />G4. AIFH MAN 2,200 LBS..TAONTH
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<br />p3ACHNE COXIITION
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<br />14. UNIT
<br />SK �TNIJMOCR
<br />�•
<br />'p `"`-"• I CFRIIFY THAT
<br />MY TOTAL
<br />AHF' TOTAL
<br />U
<br />NO.
<br />TYPE, a
<br />Y OI
<br />-- •+'i.a
<br />WASTE STREAMS
<br />ONE OF THE
<br />FOLLOWING
<br />- _ _. _ , .. a. ..,. .�. .. .
<br />• �... ` y a. .e. u - .a...ay r �.• s L w.,. , . v e 7T. -.Tr z-c:r a�-1 t . + a.. s�.a tia- e
<br />w •'- ` -' •'• . Y CATEGORIES.
<br />sfYt_r.Pl;✓:tiE/4 1 I.ID#E t3$.li! �aC f T?: tEiF?t1�t1.i:�)r"C�� y ri17117,17,, no:-29� D--1Wi.rq E? 4 t ��, c
<br />0 TO <'PO LB6.rM0rJTH
<br />2
<br />CASH R I TOTAL RECEIVED
<br />PREVIOUS
<br />i CREDIT
<br />SACRAMENTO
<br />APPLY PAYMENT TO:
<br />❑ TODAY'S SI.HVLCQ.lALE I`{
<br />❑ PREVIOUS BALANCE AS rCLLO'1i3
<br />INVOICE III AMUUN i S L
<br />MANI
<br />LIMCLII t AMU tvU• AMEX
<br />EFI] Mc VISA
<br />CUSTOMER REFERENCE
<br />L-1 mtg t1am�' a N'.1I I CCRT1i'Y TI UT NO MATERIAL CHANGE IIAS OCCURRED USA CPA ID NO. -
<br />{{ �•L lb.+l.'r.�g EITHER IN THE Ci IARACTFRISTIn9 OF THE WASTE
<br />CA A 19 MATERIAIS UH IN THE PROCESS GENERATING THE STATE ID IVO
<br />WASTE MATERIALS.-
<br />I AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TC:Rds AND
<br />TOTAL CHARGE
<br />)•
<br />.,m.
<br />CONDITIONS SET FORTH ABOVE AND ON TI IC RCVCnSE SIDE OF )HI.•: NOCUMENT.
<br />PLEASE CHARGE MY ACCOUNT FOR THIS TRAN9ACTION UNLESS OTHERWISE
<br />INDICATED IN THE PAYMENT REL:LIVEU SECTION. THE INDIVIDUAL $XINING THIS
<br />DOCUMENT IB OULY AUTI IOnaco TO SIGN AND GINO CVMMER TO ITS TERMS.
<br />(FRAM ABOVE)
<br />INITIALS
<br />(Z)
<br />t" (9
<br />� 0)
<br />VO LBS. '2.200 LBSJMONTH
<br />— IMMALS
<br />TOTAL DUE `".
<br />UO NOTWRiTCI' M,RRC
<br />i } '" !• "' ;F
<br />17th+j�9r.'?....,i��< o .l. ! ' ':�1'I
<br />SEE) ,Y
<br />M,6 is to Ow4 VW. pw tbav AW441mw• %as pmpaV dda"fio. rvkaged. R Xed av! W." aid 8,0N
<br />cawan `w,•'v•
<br />Print Customer Name / 1
<br />•�, �-;�:
<br />G4. AIFH MAN 2,200 LBS..TAONTH
<br />L-1 mtg t1am�' a N'.1I I CCRT1i'Y TI UT NO MATERIAL CHANGE IIAS OCCURRED USA CPA ID NO. -
<br />{{ �•L lb.+l.'r.�g EITHER IN THE Ci IARACTFRISTIn9 OF THE WASTE
<br />CA A 19 MATERIAIS UH IN THE PROCESS GENERATING THE STATE ID IVO
<br />By: v g
<br />Custompes Authorized R©presentative
<br />Twig A(dCFFAAGAIT fl.Ohrr%li SFC f1A1 TWE: OCllC:OOC 12I171C
<br />WASTE MATERIALS.-
<br />I AGREE TO PAY THE ABOVE CHARGES AND TO BE BOUND BY THE TC:Rds AND
<br />TOTAL CHARGE
<br />)•
<br />.,m.
<br />CONDITIONS SET FORTH ABOVE AND ON TI IC RCVCnSE SIDE OF )HI.•: NOCUMENT.
<br />PLEASE CHARGE MY ACCOUNT FOR THIS TRAN9ACTION UNLESS OTHERWISE
<br />INDICATED IN THE PAYMENT REL:LIVEU SECTION. THE INDIVIDUAL $XINING THIS
<br />DOCUMENT IB OULY AUTI IOnaco TO SIGN AND GINO CVMMER TO ITS TERMS.
<br />(FRAM ABOVE)
<br />WASTE MIN.
<br />(FROM ABOVE)
<br />r( `
<br />E
<br />TOTAL DUE `".
<br />UO NOTWRiTCI' M,RRC
<br />i } '" !• "' ;F
<br />17th+j�9r.'?....,i��< o .l. ! ' ':�1'I
<br />SEE) ,Y
<br />M,6 is to Ow4 VW. pw tbav AW441mw• %as pmpaV dda"fio. rvkaged. R Xed av! W." aid 8,0N
<br />cawan `w,•'v•
<br />Print Customer Name / 1
<br />•�, �-;�:
<br />By: v g
<br />Custompes Authorized R©presentative
<br />Twig A(dCFFAAGAIT fl.Ohrr%li SFC f1A1 TWE: OCllC:OOC 12I171C
<br />
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