Report (103) Scheduled . Date
Work Order# 'g'/ %4 _.
River City Environmental, Inc.
P.O. Box 30087 503-252-6144 Complete Industrial
Waste
Portland, OR 97294 OR CCB# 147355 • WA CCB# RIVERCE981 BT Septic Takemoval Cleaning
.L Sump
PeYeVj#9L1A2 Ote-063'f Line Cleaning , \
, / L.G. r 6 z,'' V ri Site Information ' S
.4 ,
,, t /t J, ((' °' 1 1
1'
Description Units Amount
Instructions: Driver Notes
1
River City Environmental,Inc. is in no way responsible for damage to any vehicles,personal or real property.
Terms:Net 10 days. 1.55 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,an 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 and vehicles of River City Environmental, Inc. have been instructed to enter.This includes, but is not
limited to driveways,trees, power lines or poles and building structures.
If River City Environmental finds it necessary to add liquid to the tank on job site,customer will be charged for the additional gallonage result-
ing from these conditions.
Customer agrees to reimburse River City Environmental 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 considered 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 Authorized by (please print) Date / /
Signature ,, ———
Service Tech #14<e:,,' _30'01 ,r. Service Tech #2 Date5° /0 IT' Time /C /(i
TIGARD SAND iiit GRAVEL, LLC
P.O. Box 4810
TUALATIN, OR 97062 Ticket#: I Ø447Ø9
503-692-1800 Date: 1118/'
Time:
CUSTOMER INFORMATION JOB INFORMATION ---
1 C"
ID:
ID: PO#: t I en
it/if t i/i I Name: /14 ;q in , 7001 11(3)(1Ni 41 1) i 8
Name:
1-11_,PI Itt 4 I..1-1“ I,Ni irlyff 1.1 I It 'ti f i" 1# ! , 1A II' i '1 01.JP%' I
Address: Address:
, t
i i triune, i itti i ii i i i i til 'il„, Ali [ ti
I'
0
I '
0
Truck and Carrier Information Truck Weights -- X
Truck ID: ,ii i ti it li , ti,,,t , i i, Gross Tare Net Olt a!
Descript:
PRODUCT AND LOAD TOTALS -4.1
..
ID: 1,,, 1 TODAY .iti, TO DATE 1 C
Name:
7 ,
,,- /* OM'
Received By: Iii 2ti i — - t a ri msTriform r•e-,ov