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1 <br /> SALES REPRESENTATIVE : Nick McGowan <br /> 1219 KANSAS AVENUE, MODESTO, CA 95351 <br /> TEL: I-8774241950 <br /> ELECTRONIC WASTE RECOVERY CENTER <br /> Instructions. <br /> Please complete the information below in reference of each shipment of electronics. <br /> Approximation is okay. Feel free to attac•'i' any supplementary data or information . .: rLy ._ 14V try <br /> Physical addresses only, no Po sox's accepted . <br /> . 14 Contact Information - PLEASE PRINT CLEARLY fate : <br /> Company Name:' �r� t l rcv�ti <br /> Contact Person : <br /> Physical Address : I 49 ��m ` � �� j� Signature <br /> City, State, Zip : 3. E �c <br /> , 3.CQ \r% v, t , �\ INSTRUCT! Ns: CL�� ��tiv� ��J5 � o �' C1� 60 7 <br /> Phone Number: � � .. � �� w � � �; ' <br /> Item Quantity Weight Other Items Quantity Weight <br /> Televisions - CRT liJ J r <br /> Monitor <br /> Flat Screens - CEW <br /> CPU 's� Complete <br /> CPU 's- Not Complete wwww { <br /> Laptop ( Good ) I ilk <br /> O <br /> Laptop ( BAD ) � r <br /> Tablets <br /> kPads <br /> Printer (X4arge ) <br /> Printer ( Large ) <br /> Printer ( Medium ) <br /> Printer (Small ) <br /> Scanners <br /> Keyboard ( Mice <br /> VCR <br /> Stereo / Tape / CD <br /> Copiers <br /> Fax Machines <br /> Misc. CPU Parts <br /> Microwaves <br /> Typewriters <br /> Wire/Cabling <br />