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Company Name: <br />Client Signature: <br />Printed Name & Title: <br />Driver Signature: <br />ENVIRONAINITAL <br />LOG STICS <br />P.O. Box 806 • Colton, CA 92324 <br />info@environmentallogistics.org <br />(888) 641-3940‘ EPA IDMAR00021Z513 , <br /> <br />Generator: f ora A ilvt<tf-1 cci <br />Job Address: 2 3S W- wASTIWG-Or-i ei <br />City/State/Zip STOCKIO/N) c;y9 gsel 03 <br /> <br />Site Contact: <br /> <br />Phone: 510 c3-1 2_ (9_5_13 <br />P.O. # <br /> <br />11 I II 11 H,I <br /> <br /> <br /> <br />wo # 509880N <br />INVOICE # <br />Date: I- 13 c21 <br /> <br /> <br />Sales Rep: <br />91- t OA- 0- <br /> <br />Bill To: <br />Address: <br />City/State/Zip <br />Contact: <br />Email: <br /> <br />oos" caci 0 cZo <br />CA- <br />Ve-1/4/44,,t) <br />e <br />Description Manifest/BOL Quantity Rate Total <br />D,6121)541 <br />3/tq 1 )1, At, CAla t_li.r1 ALO k) -14-A7- ln- <br />r-or ff al Lo-n4 (L1 ; n )4,44,r,e..4 /54L'/2-4 02 45 1 'ripe> <br />Pb1.4)1_#(:zz_i1-‘) (--4 4 <br />VIZI Eon du 1 11- i \541 366 z <br />-1-qS <br />, 0 "hl- . g://‘) i- G2 (040 gerpki Catits ) co-i 45' 743- <br />455 <br />p b.. <br />7 43" <br />rt1=Q:=14- Equipment / Services / Supplies Quantity Rate Total <br />PPM Onf I -it 1 Db 6 , 7 <br />L4t-i) 5IE t' 11-- . 41-12c -712 7 /4.15 <br />row6p- utJ'i -i- il. LIS 7 46- <br />7 <br />tN--iCuc -1-001-s C 5 ttpo t5' IC q rtoi,k5 6Ic. ) 1 / <br />vica3 e N) Liy,zo L) /005-- <br />0 t (0 35 .2./z) <br />/4 lc_ - m 1 Moi cto.4) gtotitiitoJIOclUote 106 3010V67 <br />Position Personnel I Start 1 Arrive Depart End Straight Rate OT Rate DT Rate Total <br />?tut\ Li A.4. Y i-c- e010, C't) 0700 J/ /.5-- / 0 0 7 ci5- 44 3 <br />DP-- I P.co Givi Lit.0\( (Sr° 010-0 ci/Lq- 09° <br />ir.) P A;itte 601-1c4et_ 04-3-0 0-700 /II c- 1 2-36 7 g6 5,"5 <br />T St92-tv1-(nowt42- or30 070-o ///5-i 210, 7 Lft• <br />d \)06 0, kaq AN 140 0 cro 0700 inc.' / 23 0 7 <br />P-Mil 100o ut CI ft 033067 (2-0 # 14-7250 07 .6--b <br />(0--S il d..0 Pt re-7, 000 cr7c. /tic /27D 7 A-z) a.522...._ <br />15 55 Job Notes: A 15`)/0 Environmental/Energy & <br />08.) e cOniTApkWri TG Soi.L- Securities Charge may apply <br />, _ A• q <br />-/) r>'14S ce- L (Yoe- 1---Lo/7- I tA-0 <br />It is the generator's responsibility to correctly identify chemical composition. If the <br />material is rejected by the disposal site, the generator agrees to pay all testing, <br />disposal, and transportation charges. In the event of any litigation arising from this <br />agreement, the prevailing party is entitled to reasonable attorney's fees, <br />expenses, and costs. Invoice subject to a 1.5% monthly interest rate on past due <br />amount. Your signature acknowledges that you have read the state required <br />notifications on the back of this document and that you are duly authorized to bind <br />your company for the above services and associated cost.