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FORWARD <br /> S1TE TICKET s GRiD <br /> INCORPORATED <br /> l,l�. s - ,t I , <br /> 999 South Austin Road/WOGHING LOCATION P O Box 633b WEIGHMASTER <br /> t�, CA 95336 Stockton, CA 95206 ' <br /> a (209) 982-4298/WEIGHING LOCATION Main Offrce (209)466-4482 DATE IN TIME IN <br /> esource Recovery (209) 982-4936 Fax (209) 465-0631 '�::r -_17-7-TT-7— " `P 3,-, <br /> t' 4 l DATE OUT TIME OUT <br /> W--1" ,�� <br /> VEHICLE BOLI_OFF <br /> REFERENCE ORIGIN <br /> OTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> Y s3 J f1;I <br /> EIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature is <br /> this certificate who is a recognized authority of accuracy as prescribed by Chapter 7(commencing with Sectoon 12700)of Division 5 of the California Business <br />-id Professions Code administered by the Division of Measurement Standards of the California Department of food and Agriculture <br /> NET AMOUNT <br /> • <br /> TENDERED <br /> A 1�1 "' ", <br /> CHANGE <br /> CHECK NO <br /> DRIVER'S SIGNATURE <br /> Jr f f �fi <br /> • <br />