Attachment D - Leachate Hauling Invoice Template.pdf

This is a Landfill Leachate Hauling Invoice Template prepared for the West Virginia Department of Environmental Protection's Landfill Closure Assistance Program. The template is designed for tracking and billing leachate hauling services from landfill facilities to disposal sites. The document outlines the invoice structure for hauling services to the Cowen Wastewater Treatment Plant (WWTP) in Cowen, West Virginia, with entries for two separate hauling dates in March 2019 (March 1 and March 2). The template accommodates vendor information, purchase order details, and requires a vendor number for tracking purposes.

Pricing for the leachate hauling service is calculated on a per-gallon basis at a unit price of $3.1229 per 100 gallons, with total pricing calculated using the formula (Gallons/100) × Unit Price, rounded to two decimal points. The sample entries show 15,000 gallons hauled on each date, resulting in individual line totals of $468.44 per shipment. The template indicates a total potential invoice amount of $936.87 for the two hauling events shown, with provisions for additional line items to accommodate ongoing hauling operations. The vendor address listed is 601 57th Street S.E., Charleston, West Virginia 25304, and the invoice includes signature and print name fields for authorization.