Report (27) f
ACTf�`'\RESIDENTIAL SEPTIC SEI SCE Page 1 of 1
River City Environmental, Inc. Work Order # 0000194511
P.O. Box 30087
Portland, OR 97294 Scheduled 7/24/2019
Phone: (503) 252-6144 Route: SEPONCALL
Salem: (503) 363-2464 Requested 7/22/2019 11:35:30AM
Vancouver: (360) 896-5256 Requested By Curt 503-519-3231
Time Window 1 1
Account#-Site # 024557 - 0013 Arrival Time: J'20 Depart Time: iU-cu 0.0.1
Curtis Heintz Excavation
,,site 4lnforrrtation
PO Box 1105 '''''.:7- 01-:%17.)-41t -'
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Sherwood,OR 97140-1105 Curtis Heintz Excavation
(503) 925-9400 12465 SW 112th Ave Nex'I''‘tt
Tigard, OR 97223-4002 PL IA rl to(— 00x3
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Status Active- Net 10 Days \' \4. S‘,.-:: \i�-iN-, 'N .
PO # Contact: Curt (503) 519-3231
Type Description Units
CRSS
1SEPINS INSPECTION 1
1SEPLOC LOCATE, UNCOVER&RECOVER TANK
1SEPOVG SEPTIC OVER 1,000 GALLONS ( Y r;``i 2 c0 cil4;
1SEPPUMP SEPTIC SERVICE FIRST 1,000 GALLONS 1 000
Work Order Notes: Please call Curt when you arrive @ 503-519-3231 pump septic and the lids are exposed Thank
you
Notes from driver:
7.721.,,A.,4---1,40 .1/200 ,
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TERM AND CONDITIONS / THE RIGHT1TO 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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DRIVER SIGNATURE DATE CUSTOMER SIGNATURE DATE
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TECHNICIAN SIGNATURE DATE Date Printed 7122/2019 11 35:49AM