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04/14/2009 13:56 FAX 209823909' IR 010/020
<br /> DM SEE C
<br /> F,�FRVPCZ ORDER AND RENTAL AGREEMENT
<br /> OBox 9c,
<br /> N, (9Pb-QS2&6•Izo')iRza-Ftto fwl7J9) 81.10
<br /> 6d*a&FA'93-6110
<br /> WS734'� N7iW ACCOUNT UAT�.I'mca"t1 ;• Z;
<br /> 3`s.'eial" m310,9/04,., 1,4.r.;A'Sa
<br /> LOCATION It kµ
<br /> UUALIT SERVICES
<br /> 1 COUNTRY MANOR ;t,l., ':�!r 'r,l','•Y,.;.r;+.;";;;,.:,:.w:<,��`,-'��+pti �9,�.,,n.z:o:..:.: � i'�ura•. ,
<br /> 5
<br /> 17 ee!?r+oS} 1&E QIR
<br /> 'ci N. T'RETHEWRY ROAD
<br /> LOCKEFORD w y "s'St:,. GR�•ti.,.,,:-w,�a�._.:.,....
<br /> BILLTO11(•'•%.�'+. � j'
<br /> 41UAL I T
<br /> Y SERVICES ';',,;y � �.,!„ �,...,.;:,; �'
<br /> 27348 E. HWY 140 I OTY DESCRIPTION J%T MOUNT
<br /> SERVICE
<br /> CR 95320 pjE �A7
<br /> SERE REQUEST a�•• l,2 "s(.
<br /> PIMP SEPTIC
<br /> INSTRUCTIONS
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<br /> RIF ME BTAWTEOPM/ TIME OMPLETED• '•'0 AM
<br /> / l/ TOTAL MATERIALS
<br /> PM .-�..—� t_._
<br /> Insuoimtwre REGULATORY COMPLIANCE CHARGE
<br /> arMry nalu MI4009 tbattha above rnrR baa�tlaen uaNeotarylY twlndlalmr 1
<br /> I as.with me tering eM cendlilam en the oppeglw Side 0 MIS contract-
<br /> EERVIDE 19 Pol&ADED ATTHE OPTION OPTNE LESSEE.', LA BOR
<br /> PAYMENT DUE UPON RECEIPT ;,, ; TAX
<br /> PAY THIS AMOUNT
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<br /> Sitl11eNn ebew aengnwlu eeeeptelwe of above"'K ee being
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