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FORWARD SITE TICKET GRID <br /> V►'' INCORPORATED 01 1144U48 V-Vtj <br /> J9uth,Austrn Road/WEIGHING LOCATION P O. Box 6336 WEIGHMASTER <br /> CA 95336 Stockton,CA 95206 L. MAf~GUE� <br /> Lan 1 (209) 982-4298/WEK'-Hir4r,LOCATION Main Office (209)466-4482 DATE IN TIME IN <br /> ource Recovery.(209)982-4936 E Fax (209)465-0631 7�1 ' <br /> 38 <br /> 866540 V DATE OUT TIME OUT s <br /> SEMCO -f 08/11 /99 08:53 <br /> MARK DREWRY VEHICLE ROLL OFF <br /> 1217 SOUTH 7th STREET RHT 990 <br /> MODEST© CA 95351 REFERENCE ORIGIN <br /> 66500 ELSON READY MIX <br /> Scale 1r Gross Weight 67680 LB Inbound - Charge ticket <br /> 5 <br /> manual Tare Weight 32720 LB <br /> Net Weight 34960 LB n= <br /> CITY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 17.48 TONS Class 11 Soil by Ton <br /> WEiGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmoster whose signature is <br /> on this Certificate who is a recognized authority of accuracy as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business <br /> and Professions Code administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> MANIFEST # 76555 NET AMOUNT <br /> . TRUCK ## 9C31389 <br /> P.O. # NONE PROVIDED TENDERED <br /> TRAILER # YC5460 <br /> Schedule 24 hours in advance directly with the landfall . CHANGE <br /> Call. (209)982-4298 to schedule. <br /> Drive Safe 1 y t ! CHECK NO <br /> l �L f I� nape <br /> DRIVER'S SIGNATURE � i�recycled r <br /> t <br />