Laserfiche WebLink
°"Jun - 5 . 2003" 1 :29AM'a "'Glag6ar Environmental 4at'%1AL—MA No 0648 P , 4 `J 0031007 <br /> ® <br /> 40985 <br /> GOLDEN STATE METALS, INC. TANK DISPOSALRM <br /> P.O. lox 70188 1 2000 E,BNndags,Lana / <br /> S9akereffeld,California 93387 ®ate �,, 5P— <br /> • Phone mm s27-3SS9 a Fax{8001327-0700 Contractor's <br /> Swap Morale.Promising &Reoycling <br /> License No. <br /> Oontraator's <br /> Phone No. <br /> CONTRACTOR: <br /> ADDRESS: <br /> JOB SITE: <br /> ADOREEi$: ( �► y <br /> DESTINATION: Q.S.M. • 2000 E.BRUNDA®E LANE • BAKERSFIELD,CA 03387 <br /> HAULER: � LICENSE NO: <br /> WEIGHIT CERT.NO: <br /> EFlSD PEpMIT N4: <br /> OTY OALLONIII BERIALNO, NE1'TONS TOTAL <br /> .t4 <br /> COUNTY: <br /> aM q�dRr <br /> Bso @4 <br /> '.a <br /> C?Z <br /> Loco o � ,.,. : ...®'. <br /> -T INSPECTION 2000 ,er <br /> C AN <br /> LEAN A DRY( EPT), OR <br /> RESIDUALS PRE (REJECT) aoeo 1,82 <br /> LEL RP!. Gk 2.®s <br /> . OXYGEN CONTENT Taeb 8,24 <br /> DISPOSAL FEE <br /> sa►o a.e2 <br /> SCRAP YALUE <br /> 12000 "4.62 <br /> OTHER P <br /> ® + TOTAL <br /> WIN <br /> All fess incurred ore per losd unison specified. Terms are <br /> net 30 days from rece:lpt of tank. Contractor's signature <br /> reprasants oeoaptance of terms for payment,and confirrns <br /> that tank removal complies With State laws. <br /> ���CClll L../ '® ,�'� V�•,a/As <br /> CONTRACTOR'S SIGNATURE <br /> CERTIFICATE OF TANK DISPOSAL/ DESTRUCTION <br /> 101 TO CERTIFY TH CEIPT AND CCEPTANCE OF THE TANKS)AS SPECIFIED ABOVE. ALL MATERIAL SP IFIED WILL BE COMPLETELY <br /> DESTR VED FOR so v gECY IN OPPOSE ONLY. <br /> At jaK <br /> AUTH0 <br /> DATi <br /> OVwrx—ce r y . VIBA.OW—lgliG®►Y - ► — Qear <br />