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FORWARD "SITE TICKET GRID <br /> INCORPORATED <br /> 1999 South Austin goad/wEiGkflNc LOCATION <br /> oN P O Box 6336 �N, , <br /> V a, CA 95336 Stockton, CA 95206 " <br /> (209) ^82-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> 'es ice Recovery ,'") 982-4936 Fax (209) 465-0631 - <br /> iJtC /� DATE OUT TIME OUT <br /> j44r <br /> VEHICLE ROLL OFF <br /> REFERENCE ORIGIN <br /> �r r <br /> OTY UNIT ee DESCRIPTION RATE EXTENSION TAX TOTAL <br /> r i <br /> NEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature is <br /> Dn this Certificate who Is a recognized authority of accuracy as prescribed by Chapter 7(Commencing with Secfion 12700)of Division 5 of the California Business <br /> and Professions Code administered by the Division of Measurement Standards of the California Department of Food and Agriculture _ <br /> NET AMOUNT <br /> iTENDERED <br /> CHANGE <br /> CHECK NO <br /> DRIVER'S SIGNATURE <br />• <br />