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CCOF SIDENTIAL SEPTIC SER`'TCE Page 1 of 1
River City Environmental, Inc. Work Order # 0000193561
P.O. Box 30087
Portland, OR 97294 Scheduled 7/18/2019
Phone: (503) 252-6144 Route: SEPONCALL
Salem: (503) 363-2464 Requested 7/10/2019 11:25:48AM
Vancouver: (360) 896-5256 . ° Requested By Debra
-4-7,- , Time Window 12:00 PM - 5:00 PM
Account#- Site # 021899 - 0001 Arrival Time: Depart Time:
Debra Johnson
9695 SW Darmel Ct Site Information
Tigard, OR 97224-5702 Debra Johnson
(503)997-2022 9695 SW Darmel Ct
Tigard, OR 97224-5702
Status Active-Credit Card on File
PO #
Contact: Debra Johnson (503)997-2022
Type Description Units Rate Total
CRSS
1SEPINS INSPECTION 1
125.00
1 SEPLOC LOCATE, UNCOVER&RECOVER TANK 98.00
1SEPOVG SEPTIC OVER 1,000 GALLONS 0.45
1SEPPUMP SEPTIC SERVICE FIRST 1,000 GALLONS 1 a.,,C,) 395.00 -S el Sc..- , ,
Subtotal:
Total:
Balance Due: tf S .'-;
Work Order Notes: CCOF- Ordered by/onsite contact is Debra please call en route. Need to pump tank. Lids will be
exposed.
Notes from driver:
' ....(1 lLA / COO 6i 15
TERM AND CONDITIONS THE RIGHT TO LIEN
River City Environmental,Inc. is in no way responsible for damage to any vehicle, personal or real property.
Term: Net 10 Days. 1.5%per month will be charged on past due accounts(18%annum).
The customer agrees to pay all invoices arising out of services,and any 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 for 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 not limited to driveways, trees, power lines or poles and building structures.
If River City Environmental finds it necessary to add liquid to tank on jobsite,customer will be charged for the additional
gallonage resulting 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 of the work order is considered an original. Redeemable in Multnomah County
Oregon CCB# 147355 Washington CCB# RIVERCE981BT
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DRIVERSI TURE DATE CUSTOMER SIGNATURE DATE
TECHN IAN SIGNATURE DATE
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