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SITE SITE TICKET t CELL <br /> FORWARD LANDFT`- <br /> 9999 S AUSTIN WEIGHMASTER *.I/ <br /> CUSTOMER 4 DAT M N DATE/NME OUT <br /> 010634 04-34 2Q1Fa 9- 20 VEHICLECONTAINER^ <br /> JIM THORPE OIL INC. <br /> MARTIN THORPE REFERENCE <br /> 357 NORTH BECKMAN RD. <br /> BILL OF LADING <br /> 9209159694 <br /> SCALE IN GROSS WEIGHT 43,080 NET TONS 3.58 <br /> SCALE OUT TARE WEIGHT 35, 920 NET WEIGHT 7, 160 INBOUND <br /> OTY. UN, SION'. "T <br /> 18-OC YD TRACKING QTY RE EIV <br /> 3.5 TN SW-CONST DEBRIS STOCKTON <br /> 1. ENVIRONMENTAL FEE 1 r. <br /> 1.010FUEL RECOVERY FEE <� ? <br /> APR2 4 2015 <br /> ENVIRONMENTAL <br /> AN- <br /> ' -5 t r,'" ' \ 41Cp1T nCOCOTIA MT <br /> a 4 <br /> "14 Atm ^n'e <br /> TENDERED <br /> The undersigned individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions CHANGE <br /> on the reverse side and that he or she has the authority to sign this document on behalf of the customer. <br /> CHECK# <br /> RS-F042UPR(07/12) SIGNATURE <br /> SITE SITE TICKET If CELL <br /> FORWARD LANDFILL <br /> 9999 S AUSTIN RD WEIGHMA.M. <br /> CUSTOMER D*IqFQpjtte OATERIME OUT <br /> 010634 VMC-L;4-2015 —CONTAINER - •�� *• <br /> JIM THORPE OIL INC. <br /> MARTIN THORPE <br /> 357 NORTH BECKMAN RD. BILL OF LADING <br /> 4204154694 1235177 <br /> SCALE IN GROSS WEIGHT 43, 080 NET TONS 3.58 <br /> SCALE OUT TARE WEIGHT 35, 920 NET WEIGHT 7, 160 INBOUND <br /> 18. YD TRACKING QTY r <br /> 3-5E TN SW—CONST DEBRIS STOCKY` <br /> 1. ENVIRONMENTAL FEE 1 _•, x, ygcy;., <br /> 1.0c FUEL RECOVERY FEE <br /> TENDERED <br /> The undersigned Individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions CHANGE <br /> on the reverse aide and that he or she has the authority to sign this document on behalf of the customer. <br /> CHECK# <br /> RS-FO42UPR(07/12) 201 SIGNATURE <br />