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MMEMMS <br /> HCI ENVIRONMENTAL & ENGINEERING SERVICE <br /> HCI www.HCIENV.com <br /> Corporate Office: 114 Business Center Drive • Corona, CA 92880 • 800.988.442 • Fax:951.280.07 18 <br /> N. California: 915 L.Street,Ste. C,Sacramento, CA 95814 • 800.988.4424 <br /> Nevada:3710 E.Sunset Road,Ste. B, Las Vegas, NV 89120 • 800.988.4424 <br /> CA:A-General Engineering State Contractors License 788216•E.P.A.I.D.#CAR000176826 Hazardous Waste Transporter Registration#5464 <br /> NV:A-General Engineering State Controctors License 0075367 <br /> Bill To Generator <br /> Date Work Order Number <br /> Address �wr P . r lS �i ✓l- Cl . /5 /� HCI— ,j Z <br /> Address PO <br /> �,�7 _ Start Time <br /> /'7invr �✓r . 3/U / <br /> City State Zip Code City State Zip Code Project Man ger Onsite <br /> / / End Time <br /> 2Q5,_ ST Szc <br /> Contact Person Phone# Contact Person <br /> Phone# Sales Person Facilit <br /> CITY CONTAINER <br /> slzE MATERIAL DESCRIPTION MANIFEST PRICE PER TOTAL <br /> NUMBER UNIT PRICE <br /> ADDITIONAL NOTES <br /> I agree that the above referenced work was accomplished in a timely and professional manner We agree to pay all charges directly <br /> related to the above referenced work.In the event collection of any amount shall opium formal action,thephooling parry shall be <br /> entitled to il'S costs and attpmey's lees.Past due invoices are subject to an 18%per oar or 1.5%per month Interest rate. <br /> TOTAL <br /> PRINT NAME F.. '-11IIiNATUREr_ \ "i— I <br /> -PHOTOCOPY OF <br /> 0DASTO: <br /> �gwASTE <br /> www.GREENIN7.com DTSC Generator Manifests <br /> PO Box 400 <br /> Sacd amento,CA 95812.0400 <br />