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i <br /> to <br /> FORWARD SITE TICKE"f GRID <br /> V► INCORPORATED - <br /> _ - 4 144159 D-98 <br /> 99,2&uth Austin Road WEl HIN"�LOCATION P O Sox 6336 WEIGHMASTER <br /> 1 ,CA 95336" Stockton,CA 95206' K• SPARKS <br /> an (209)982.4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> esource Recovery (209) 982-4936 Fax (209) 465-0631 08/11 /99 12 t 46 <br /> 956500 DATE OUT TIME OUT <br /> SEMCO 08/11 /99 12:46 <br /> MARK DREWRY VEHICLE ROLL OFF <br /> 1217 SOUTH 7th STREET TAYLOR Tq <br /> MODESTO CA 93351 REFERENCE I ORIGIN <br /> 866540 NELSON READY MIX <br /> Scale 1 Gross Weight 75080 L9 Inbound - Charge ticket <br /> Stored Tare Weight 34400 LB <br /> Net -Weight 44680 LD <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTALI <br /> " <br /> 20.31 TANS Class II Soil by Tan € <br /> i'p S <br /> VEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmoster whose signature Is <br /> ,n 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 /> ind Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> NET AMOUNT <br /> . <br /> MANIFEST # 148705 <br /> TRUCK # 9C51070 <br /> P.O. 9# NONE PROVIDED TENDERED <br /> TRAILER # IVZ5747 <br /> Schedule 24 hours in advance directly with the landfill . CHANGE <br /> Call (209)982-4298 to schedule. <br /> Drive Safe 1 y ! f CHECK NO <br /> recycled paper <br /> DRIVER'S SIGNATURE <br /> r <br /> f <br /> C <br /> • i - <br />