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Report COD 1111!11 11$11111111(hil l I Ili pc. aoo 9 -00. Date 08/22/09 Scheduled 08/22/09 SePtiC C.O.D. River City Environmental, Inc. Work Order # W097819 503- 252 -6144 Complete Industrial P.O. Box 30087 Salem 503 - 363 -2464 Vancouver 360 -896 -5256 Waste Removal Septic Tank Cleaning Portland, OR 97294 v w.rivercityusa.com Sump Line Cleaning OR CCB# 147355 WA CCB# RIVERCR981BT Site Information Troy Peck Troy Peck 9340 SW Mountain View Lane SW Mountain View Ln, 9380 Tigard, 97224 Tigard, OR 97224 Contact: 503 -314 -8773 503 -314 -8773 -- PO# Type Description of Work Units and Price Septic Service Septage Overage Notes 1476621/97819 - COD to driver. Needs pumping only @ three different siites. Troy wil meet you on site. c "w 0) ` L 3 3 (Rs y 11,1 %[ .l c1, Total Charges . Cz_; J L j IJ River City Environmental, Inc. is in no way responsible for damage to any vehicles, personal or real property. Terms: Net 10 days, 1.5% per month will be charged on past due accounts (18% per annum). Terms and Conditions The Right to Lien The customer agrees to pay all invoices arising out of services, and any other special services herein within 10 days. The customer agrees to pay such extra and overtime charges as may be invoiced from time to time for services rendered, over and above the normal servicing schedule. on behalf of the customer. The customer agrees to assume responsibility damage to customer's real or personal property arising from services which take place on customer's premises, where the drivers arid vehicles of River City Environmental have been instructed to enter. rhis includes. but is not limited to driveways, trees, power lines or poles and building structures If River City Environmental, Inc. finds it necessary to add liquid to the tank on jobsite, customer will be charged for the additional gallonage resulting from these condidtions. Customer agrees to reimburse River City Environmental, Inc for all reasonable attorney's fees court costs and other expense incurred by said company to enforce collection or to serve their rights under this agreement. If this work order is not contested in writing within 10 days the full amount is consiaered due and payable. Customer agrees to the above conditions. A fax on the work order is considered an original. Redeemable in Multnomah County Check # Visa MC Amex Card # Exp Date Vcode Work Autho ized ' print • ) ` Date / / �f Signature 4 Service TecF L1 E �� Service Tech #2 Date `�, Z 4 / 7 Time i i 1 T± - 603-29111=1055 ' 1 ON E LiLe [ CONVEYOR TRUCKS .s:%1 2 o618 - : [ DELIVERY'itECEIPT ts - t r, ' Date [ Sold To ...e9y 10 C 4 : t r, Company Rep. 7 - k. l° Job Name 3,9 5-3 t , t ) ) 61° I city 77 elk-cr.') 1/4‘4 1,)/(A...A L. • OFFICE CODEC7 2 3 4 5 8 7 8 9 10 11 12 13 l; Office Code Time On Job : [ 0 Hourly Service Hrs. r , r 14 Single Load Service 0 Soil I. U ,----, I -. Muni-Load Service - Tns r MATERIAL E Quantity : Description - , PitMUrntiar 6 t Ft ' • Rnd 5 g\ .....$6 Crsh •‘, 1, . • l. Yrds Rnd Tns Crsh TOTAL 1.- . .. Job Description: - r0v6)11 . r I k L' I SOME OR ALL OF TODAY'S MATERIAL WAS: r: 4E Loaded on site Picked upon customer account. - SOURCE: L DAcI4T. \ 50 c.c. 0 CASH 0 CHECK t` ! k i CONDITIONS OF THIS SALE ARE USTED ONSACK 1: PLEASE READ AND UNDERSTAND BEFORE SIONINGI : t•- r I UNDERSTAND AND AGREE TO THE CONDITIONS LISTED ON THE BACK F OF THIS TICKET"' I HEREBY A ORIZE FULL PAYMENT FOR PRODUCTS [.. , AND'SERVICES -LIVED ABO .' k Signaiure ''', ' ■.' - ' ' ;'/; 7 14 1 [ SRa .... 1 ..' ,--,.... +,