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FORWARD SITE I TICKET GRID <br /> �►� INCORPORATED 011 144104 D-98 <br /> WEIGHMASTER <br /> S ustin Road/WEIGHING LOWION P O. Box 6336 " <br /> 95336 h Stockton,CA 95206 L. MARQUEZ <br /> N g) 982-4298/WEIGHING LocATI6w Main Office (209) 466-4482 DATE IN TIME IN <br /> rce Recovery (209)982-4936 —Fax (209)465-0631 08/11/979 10%39 <br /> 1966,300 t DATE OUT TIME OUT <br /> SEMCO OS/11 /99 10:50 <br /> MARK ,,DREWRY'� -- VEHICLE ROLL OFF ` <br /> 1217SOUTH 7th STREET RHT 950 <br /> MODESTO CA 953'51 <br /> REFERENCE ORIGIN <br /> 866340 NELSON READY MIX <br /> Scale I Sro$s Weight 80680 LB Inbound -- Change ticket <br /> Manual Tare Weight 34940 LS <br /> Net Weight 45740 LB � I <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 22.87 TOM Class II Soil by Ton <br /> �IvIASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a welghmaster whose signature is <br /> s certificate who Is a recognized authority of accuracy as prescribed by Chapter 7(commencing with Section 12700)of Division 6 of the CallfoMIa Business <br /> rotesslons Code,administered by the DMsion of Measurement Standards of the California Department of Food and Agriculture <br /> MANIFEST # 49694 NET AMOUNT <br /> TRUCK # 9A43973 <br /> P.0. # NINE PROVIDED TENDERED <br /> TRAILER # IUY6469 ` <br /> Schedule 24 hours in advance directly with the la�dfx ll . CHANGE <br /> Call (209)982-4298 to schedule. <br /> Drive Safely ' # CHECK NO <br /> �' recycled paper , <br /> DRIVER'S SIGNAT W <br /> f r I <br /> t <br /> • l r <br />