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FORWARD' <br /> v SITE TICKET GRID <br /> INCORPORATED 01 144120 D--98 <br /> 92Woulh Austin Road/WEiGHING LOCATION P O Boi%&336 WEIGHMASTER <br /> CA 95336 StocktonpCA 95206 K. SPARKS <br /> La III (209) 982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> Resource Recovery (209) 982-4936 Fax (209)4k5-0631_ 013/11/q9 11 : 16 <br /> 866501 DATE OUT TIME OUT <br /> SEMCO 08/11 /99 11 : 16 r <br /> MARK DREWRY VEHICLE ROLL OFF <br /> 1217 SOUTH 7th STREET TAYIQR T5 <br /> MODESTf3 CA 95351 REFERENCE ORIGIN <br /> S6650 NELSON READY MIX <br /> Scale I Grass Weight 77100 LB Inbound Charge ticket =� <br /> Stored Tare Weight 33300 LB ` <br /> Net Wea i h t 43800 LR <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 21 .90 TONS Class II Sail by Ton <br /> WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the fWowing described commodity was weighed measured or counted by a weighmaster 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 Callfomla Department of Food and Agriculture — NET AMOUNT <br /> MANIFEST # 49695 <br /> TRUCK # 9A93261 <br /> R.D. # NONE PROVIDED TENDERED <br /> TRAILER # 1WD9967 <br /> Schedule 24 hours in advance directly with the landfill . CHANGE <br /> Call t219l982-4298 to schedule. <br /> Drive Safe 1 y f I CHECK NO <br /> A' recycled paper <br /> DRIVER'S SIGNATURE ti� <br />